The impact of preoperative nutritional status on surgical outcomes in emergency abdominal procedures

Background: To evaluate how preoperative serum albumin levels and BMI correlate with surgical outcomes in emergency abdominal surgery patients and to identify reliable predictors of post-operative complications and mortality for enhanced risk stratification and patient care optimization. Methods: This prospective observational study included patients undergoing emergency abdominal surgery at our tertiary care facility between January 2021 and November 2023. We measured each patient’s body mass index (BMI) and serum albumin levels before surgery. We then tracked post-operative outcomes, including complications, duration of hospital stays, and morta lity, analyzing their relationships with these preoperative measurements. Results: Post-operative complications and mortality rates were highest in the underweight group (BMI < 18.5 kg/m²) and in patients with hypoalbuminemia (serum albumin < 3.5 g/dL). Surgical site infections, sepsis, and pneumonia were the most frequent complications observed. Patients with moderate hypoalbuminemia exhibited significantly higher rates of complications and more extended hospital stays. While trends relating BMI to outcomes were observed, these associations did not reach statistical significance in our cohort. Conclusion: Our findings suggest that serum albumin is a valuable, readily available, and independent predictor of post-operative morbidity and mortality in emergency abdominal surgery patients. In contrast, BMI did not demonstrate statistically signi ficant predictive value in this study. These results underscore the importance of preoperative nutritional assessment and serum albumin levels in risk stratification and clinical decision-making for emergency abdominal surgical patients.