Webmedcentral - Head and neck ArticlesThe Head and neck articles published by Webmedcentral
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2024-03-29T08:24:09+01:00webmedcentral logo
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http://www.webmedcentral.com/images/Header_Logo.giftext/html2010-11-10T18:46:10+01:00http://www.webmedcentral.com/Mr. Murtaza K SalemIs Low Albumin Associated With Post-operative Pharyngo-cutaneous Fistula?
http://www.webmedcentral.com/article_view/1139
Objectives: Low albumin is associated with poor outcomes in critically ill patients, whilst malnutrition leads to impaired wound healing. As low albumin has been used as a marker of malnutrition and stress response, we hypothesised that low albumin may be a risk factor for pharyngo-cutaneous fistula after surgery involving a pharyngotomy. The objective therefore was to compare mean lowest albumin levels after surgery involving a pharyngotomy between patients who did or did not develop a post-operative fistula.Methods: Prospective collection of lowest in-patient albumin level after any surgery, by single surgeon (JS), involving a pharyngotomy. Statistical analysis by t-test using SPSS.Setting was an NHS secondary care ENT/Head & Neck Unit. Participants were all patients having procedures involving a pharyngotomy under care of a single consultant (JS) between Sept 94 and Feb 07. The main outcome measures was fistula rate.Results: 75 patients had 81 procedures: 31 total laryngectomy, 18 total laryngectomy/partial pharyngectomy, 15 total pharyngo-laryngectomy, 9 partial pharyngectomy or partial laryngectomy or both, and 4 pharyngeal pouch excision, and 4 other procedures. 7 patients developed a pharyngo-cutaneous fistula. Lowest post-op albumin levels ranged from 7-42 g/L, mean 22.96 g/L. Mean albumin in group developing a fistula was 20.43 g/L, and in group with no fistula 23.20 g/L; the difference was not statistically significant (p=0.24) (93% power to detect 3g/L difference, α=0.05).Conclusions: No significant difference was observed in albumin levels in patients with or without post-operative fistula, suggesting that low albumin may be neither associated with nor a contributing cause of pharyngo-cutaneous fistula.