Preoperative serum albumin, serum prealbumin, serum transfferin and body mass index as predictors of postoperative morbidity and mortality in laparotomy cases

Abstract

Introduction: Malnutrition significantly impacts postoperative outcomes in patients undergoing emergency laparotomy. Despite advances in surgical care, the role of preoperative nutritional parameters in predicting surgical outcomes remains crucial. Methods: A prospective observational study was conducted at B.M.Patil College ,Hospital and Research Center, Vijayapura, from April 2023 to March 2025. 83 patients undergoing emergency laparotomy were included. Preoperative serum albumin, prealbumin, transferrin levels, and BMI were measured. Primary outcomes included postoperative complications, mortality, and length of hospital stay. Results: Low albumin levels (<2.5 mg/dl) were significantly associated with wound infection rates (77.8%, p<0.001). Transferrin levels <160 mcg/dl correlated with increased mortality (18.9%, p=0.04). Higher BMI was associated with increased mortality (p=0.007). ROC curve analysis showed BMI as the strongest predictor of mortality (AUC=0.735). Wound infection occurred in 48.2% of cases, with overall mortality rate of 9.6%. Conclusion: The findings emphasized the importance of comprehensive nutritional assessment in emergency surgical patients for risk stratification and outcome prediction.