(401) Pre-operative serum albumin as a predictor of outcomes after thyroidectomy

Introduction: Albumin is considered to be a surrogate marker for inflammation and nutritional status. Levels usually decrease after surgery but little is known about the predictive value of pre-operative albumin levels in patients undergoing thyroidectomy. This study aimed to investigate the 30-day incidence of post-operative outcomes in thyroidectomy patients with and without pre-operative hypoalbuminemia (HA).

Methods: TriNetX, a federated de-identified database, was retrospectively queried to identify patients who underwent thyroidectomy. Post-operative outcomes within 30 days of thyroidectomy, based on ICD-10 and CPT codes, in patients with pre-operative HA ( < 3.4g/dL) (cohort 1) were analyzed and compared to patients without HA (cohort 2).

Results: After propensity score matching, 2113 patients were identified in each cohort. HA patients were more likely to have post-operative pneumonia (OR 2.866, 95% CI [1.643-5.00]), acute renal failure (OR 2.485, 95% CI [1.617-3.817]), pulmonary embolism/venous thromboembolism (OR 1.614, 95% CI [1.019-2.557]), and sepsis (OR 2.327, 95% CI [1.21-4.473]). The prevalence of mortality, surgical site infection, use of tracheostomy, and respiratory dependence were comparable between cohorts.

Conclusions: Patients undergoing thyroidectomy with pre-operative HA have a higher incidence of postoperative complications compared to patients without pre-operative HA. While not routinely assessed, pre-operative evaluation of serum albumin levels may help guide expectations and optimal management of thyroidectomy patients.