Lower- versus upper-extremity surgery: effect on serum albumin levels

Hypoalbuminemia is one of the markers of trauma and major surgery. No study has reported on the comparison between upper- and lower-extremity surgery patients in terms of albumin levels. Therefore, the present study aimed to investigate the preoperative and postoperative serum albumin levels in patients who underwent extremity surgery and compare the changes in albumin levels after upper-extremity surgery with those after lower-extremity surgery. Sixty patients who presented to the emergency department of a tertiary care hospital due to trauma were included in the study. All the patients underwent either upper- or lower-extremity surgery by orthopedists and were consecutively selected regardless of their ages. Their serum albumin levels at the time of admission and on the third day after the surgery were obtained from the hospital patient records. A statistically significant difference in the preoperative and postoperative serum albumin levels was found in both groups (P < 0.05). Moreover, the mean difference between preoperative and postoperative serum albumin levels was found to be significantly higher in the lower-extremity group (1.52 ± 0.32 g/dL) than in the upper-extremity group (0.95 ± 0.39 g/dL) (P < 0.05). This study revealed that both upper- and lower-extremity surgeries caused hypoalbuminemia. This study was novel in finding that lower-extremity surgery caused more severe hypoalbuminemia in the patients compared with upper-extremity surgery. The reason for this significant difference was the longer duration of lower-extremity surgeries, requiring more fluid support during the surgery.