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Abstract：
BACKGROUND: Perforated peptic ulcer (PPU) is a common emergency surgical condition and a significant cause of morbidity and mortality worldwide. While advances in surgical techniques have improved outcomes for patients with PPU, many factors still affect postoperative hospital stay and overall prognosis. One potential factor is the serum albumin (SA) level, a widely utilized marker of nutritional status that has been associated with length of stay and complications in various surgical procedures.
OBJECTIVE: To clarify the correlation of SA level on postoperative day 2 with hospital length of stay (HLOS) in patients undergoing emergency surgery for perforated peptic ulcer (PPU).
METHODS: We retrospectively collected and analyzed clinical baseline data, including blood routine and SA levels, of patients who underwent emergency PPU surgery and postoperative treatment at the Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University between December 2012 and September 2021. Patients were grouped according to HLOS with 7 d as the cut-off value, and relevant indicators were analyzed using SPSS 26.0.
RESULTS: Of the 37 patients undergoing emergency surgery for PPU referred to our department, 33 had gastric and 4 had duodenal ulcer perforation. The median HLOS was 10 d. There were 8 patients in the ≤ 7-d group (median HLOS: 7 d) and 29 patients in the > 7-d group (median HLOS: 10 d). The ≤ 7-d group had markedly higher SA on postoperative day 2 than the > 7-d group (37.7 g/L vs 32.6g/L; P < 0.05). The SA level on postoperative day 2 was a protective factor for patients with HLOS > 7 d (Odds ratio = 0.629, P = 0.015). The cut-off of SA on postoperative day 2 was 30.6g/L, with an area under the curve of 0.86 and a negative predictive value of 100% for the prediction of HLOS ≤ 7 d.
CONCLUSIONS: The SA level on postoperative day 2 was associated with the HLOS in patients undergoing emergency surgery for PPU. The pre- and post-operative albumin levels should be monitored, and infusion of human SA should be considered in a timely manner.
OBJECTIVE: To clarify the correlation of SA level on postoperative day 2 with hospital length of stay (HLOS) in patients undergoing emergency surgery for perforated peptic ulcer (PPU).
METHODS: We retrospectively collected and analyzed clinical baseline data, including blood routine and SA levels, of patients who underwent emergency PPU surgery and postoperative treatment at the Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University between December 2012 and September 2021. Patients were grouped according to HLOS with 7 d as the cut-off value, and relevant indicators were analyzed using SPSS 26.0.
RESULTS: Of the 37 patients undergoing emergency surgery for PPU referred to our department, 33 had gastric and 4 had duodenal ulcer perforation. The median HLOS was 10 d. There were 8 patients in the ≤ 7-d group (median HLOS: 7 d) and 29 patients in the > 7-d group (median HLOS: 10 d). The ≤ 7-d group had markedly higher SA on postoperative day 2 than the > 7-d group (37.7 g/L vs 32.6g/L; P < 0.05). The SA level on postoperative day 2 was a protective factor for patients with HLOS > 7 d (Odds ratio = 0.629, P = 0.015). The cut-off of SA on postoperative day 2 was 30.6g/L, with an area under the curve of 0.86 and a negative predictive value of 100% for the prediction of HLOS ≤ 7 d.
CONCLUSIONS: The SA level on postoperative day 2 was associated with the HLOS in patients undergoing emergency surgery for PPU. The pre- and post-operative albumin levels should be monitored, and infusion of human SA should be considered in a timely manner.
摘要：
背景：穿孔性消化性溃疡（PPU）是一种常见的急诊外科疾病，是全球发病率和死亡率的重要原因。虽然手术技术的进步改善了PPU患者的预后，许多因素仍然影响术后住院时间和总体预后。一个潜在因素是血清白蛋白（SA）水平，一种广泛使用的营养状况标志物，与各种外科手术中的住院时间和并发症有关。
目的：明确消化性溃疡（PPU）急诊手术患者术后第2天SA水平与住院时间（HLOS）的相关性。
方法：我们回顾性收集并分析了临床基线数据，包括血常规和SA水平,在岭南医院接受紧急PPU手术和术后治疗的患者，2012年12月至2021年9月中山大学附属第三医院.患者根据HLOS进行分组，以7d为截止值，并采用SPSS26.0对相关指标进行分析。
结果：在接受PPU急诊手术的37例患者中，33例出现胃溃疡穿孔，4例出现十二指肠溃疡穿孔。中位HLOS为10d。≤7d组8例(中位HLOS：7d)，>7d组29例(中位HLOS：10d)。≤7d组术后第2天的SA明显高于>7d组（37.7g/Lvs32.6g/L；P<0.05）。术后第2天SA水平是HLOS>7d患者的保护因素(赔率=0.629,P=0.015)。术后第2天SA的临界值为30.6g/L,曲线下面积为0.86，预测HLOS≤7d的阴性预测值为100%。
结论：在接受紧急PPU手术的患者中，术后第2天的SA水平与HLOS相关。术前和术后白蛋白水平应进行监测，应及时考虑输注人SA。
目的：明确消化性溃疡（PPU）急诊手术患者术后第2天SA水平与住院时间（HLOS）的相关性。
方法：我们回顾性收集并分析了临床基线数据，包括血常规和SA水平,在岭南医院接受紧急PPU手术和术后治疗的患者，2012年12月至2021年9月中山大学附属第三医院.患者根据HLOS进行分组，以7d为截止值，并采用SPSS26.0对相关指标进行分析。
结果：在接受PPU急诊手术的37例患者中，33例出现胃溃疡穿孔，4例出现十二指肠溃疡穿孔。中位HLOS为10d。≤7d组8例(中位HLOS：7d)，>7d组29例(中位HLOS：10d)。≤7d组术后第2天的SA明显高于>7d组（37.7g/Lvs32.6g/L；P<0.05）。术后第2天SA水平是HLOS>7d患者的保护因素(赔率=0.629,P=0.015)。术后第2天SA的临界值为30.6g/L,曲线下面积为0.86，预测HLOS≤7d的阴性预测值为100%。
结论：在接受紧急PPU手术的患者中，术后第2天的SA水平与HLOS相关。术前和术后白蛋白水平应进行监测，应及时考虑输注人SA。
