{
    "abstract": "Anastomotic conversions and revisions remain crucial in addressing complications or sub-optimal outcomes following primary bariatric procedures. Preoperative malnutrition, proxied by hypoalbuminemia, has traditionally been considered a risk factor for postoperative morbidity. This study investigates the validity of this association in revisional and conversion metabolic/bariatric surgery (MBS).\nA retrospective cohort analysis was performed on 58,327 MBS revisions and anastomotic conversions from the 2020-2022 MBSAQIP registry. Approximately all cases studied were performed laparoscopically (98.8%). A preoperative albumin level of 3.5\u2009g/dL was used as a threshold to identify patients with hypoalbuminemia. We utilized descriptive statistics, univariate and multivariable logistic regression, and 1:1 nearest neighbor matching in complete-case analyses to explore the relationship between albumin levels and postoperative outcomes.\nWhile univariate analyses illustrate an association between hypoalbuminemia and postoperative morbidity, multivariable regression and 1:1 matched analysis showed hypoalbuminemia is not an independently significant driver of 30-day overall postoperative complications (including leaks), reoperation, or reintervention. However, 1:1 matched analysis demonstrated significantly increased odds of 30-day postoperative superficial surgical site infection (SSI) (OR 8.138, p=0.049) and readmission (OR 1.75, p=0.045) associated with albumin levels lower than 3.5\u2009g/dL.\nFollowing adjustment for confounding patient factors, hypoalbuminemia alone did not arise as an independent predictive factor for the 30-day major complications such as leak, reoperation, or re-intervention after revisional and anastomotic conversion MBS, although there maybe increase in SSI and readmission rates.",
    "authors": [
        {
            "affiliation": "Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH.\nLaboratory for Surgical and Metabolic Research, Brigham and Women's Hospital, Boston, MA.",
            "firstname": "Pourya",
            "initials": "P",
            "lastname": "Medhati"
        },
        {
            "affiliation": "Digestive Diseases Institute, Cleveland Clinic Foundation, Cleveland, OH.",
            "firstname": "Jerry",
            "initials": "J",
            "lastname": "Dang"
        },
        {
            "affiliation": "Division of General and GI Surgery, Brigham and Women's Hospital, Boston, MA.\nLaboratory for Surgical and Metabolic Research, Brigham and Women's Hospital, Boston, MA.",
            "firstname": "Eric G",
            "initials": "EG",
            "lastname": "Sheu"
        },
        {
            "affiliation": "Division of General and GI Surgery, Brigham and Women's Hospital, Boston, MA.\nLaboratory for Surgical and Metabolic Research, Brigham and Women's Hospital, Boston, MA.",
            "firstname": "Ali",
            "initials": "A",
            "lastname": "Tavakkoli"
        },
        {
            "affiliation": "Division of General and GI Surgery, Brigham and Women's Hospital, Boston, MA.\nLaboratory for Surgical and Metabolic Research, Brigham and Women's Hospital, Boston, MA.",
            "firstname": "Abdelrahman",
            "initials": "A",
            "lastname": "Nimeri"
        },
        {
            "affiliation": "Division of General and GI Surgery, Brigham and Women's Hospital, Boston, MA.\nLaboratory for Surgical and Metabolic Research, Brigham and Women's Hospital, Boston, MA.\nDepartment of Surgery, University of Virginia, Charlottesville, VA.",
            "firstname": "Thomas H",
            "initials": "TH",
            "lastname": "Shin"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2025 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.",
    "doi": "10.1097/XCS.0000000000001346",
    "journal": "Journal of the American College of Surgeons",
    "keywords": [],
    "methods": null,
    "publication_date": "2025-02-04",
    "pubmed_id": "39902931",
    "results": "While univariate analyses illustrate an association between hypoalbuminemia and postoperative morbidity, multivariable regression and 1:1 matched analysis showed hypoalbuminemia is not an independently significant driver of 30-day overall postoperative complications (including leaks), reoperation, or reintervention. However, 1:1 matched analysis demonstrated significantly increased odds of 30-day postoperative superficial surgical site infection (SSI) (OR 8.138, p=0.049) and readmission (OR 1.75, p=0.045) associated with albumin levels lower than 3.5\u2009g/dL.",
    "title": "Utility of Preoperative Hypoalbuminemia as Independent Predictor of Post-Conversion and Revisional Bariatric Surgery Outcomes: MBSAQIP Registry Analysis.",
    "xml": "<Element 'PubmedArticle' at 0x7885042c1710>"
}