P147. low preoperative albumin levels significantly increase odds of panniculectomy complications: a national surgical quality improvement program (acs-nsqip) analysis

PURPOSE: Panniculectomies are medically indicated after massive weight loss, which is often accomplished by gastric bypass. As most cases have an elective component, surgeons have the chance to optimize preoperative variables. We aim to investigate the role of pre-op albumin and BMI level on panniculectomy complications and post-op infections. METHODS: Panniculectomy patients from January 2005-December 2019 were identified via CPT codes 15830 and 15847 from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Multivariate logistic regression was performed on intra/postoperative bleeding and postoperative wound infection (WI) against preoperative serum albumin, diabetes status, age, body mass index (BMI), and smoking status. Odds ratios were adjusted for comorbidities. We established statistical significance at 99%. RESULTS: Out of 3,202 patients, 111 sustained intra/postoperative bleeding and 60 suffered WI. Lower preoperative albumin levels and higher BMI were both significantly associated with increased likelihood of bleeding and WI (p<0.0001). For every 1g/dL decrease in albumin, patients’ odds of bleeding increased 2.21 times, and odds of WI increased 4.52 times (p<0.0001). For every one-unit increase in BMI, patients’ odds of bleeding increased 1.04 times, and odds of WI increased 1.06 times (p<0.0001). BMI and albumin were weakly correlated (-0.32) suggesting each had independent effects on complications. CONCLUSION: In panniculectomy patients, preoperative albumin level is significantly associated with postoperative bleeding and wound complications. These findings suggest the importance of preoperative nutritional optimization, particularly aiming to increase albumin levels, to reduce complications in this population.