ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1642756
Association between preoperative albumin and postoperative pneumonia in patients undergoing major non-cardiac surgery
Provisionally accepted
- 1Department of Anesthesiology, Chongqing University Cancer Hospital, Department of Surgery and Anesthesiology, Cancer Hospital, Chongqing University, Chongqing, China
- 2Zhuhai City People's Hospital, Zhuhai, China
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ABSTRACT Background: Postoperative pneumonia is a common and serious complication following non-cardiac surgery. However, the relationship between preoperative albumin levels and postoperative pneumonia remains unclear in major non-cardiac surgeries, and the cut-off value for predicting postoperative pneumonia has yet to be determined. Methods: Data from patients who underwent non-cardiac surgery between January 1, 2019, and December 31, 2022, were extracted from the institutional electronic medical records of Chongqing University Cancer Hospital. The primary exposure of interest was preoperative albumin levels, and the outcome was postoperative in-hospital pneumonia. Results: The results revealed a non-linear dose-response relationship between preoperative albumin levels and postoperative pneumonia. A 1 g/L increase in preoperative albumin levels was associated with a 4.4% reduction in adjusted odds ratio (aOR) of postoperative pneumonia (aOR: 0.956, 95% CI: 0.940-0.973, P<0.001). Patients with preoperative albumin levels <38.9 g/L or between 38.9 and 45.3 g/L had a 67.4% and 30.3% higher OR, respectively, compared to those with levels >45.3 g/L (aOR: 1.674, 95% CI: 1.313-2.135, P<0.001; and aOR: 1.303, 95% CI: 1.045-1.624, P=0.019). Subgroup analyses indicated that the risk of developing pneumonia was more pronounced in younger, female, and healthier patients. Conclusion: These findings suggest that preoperative albumin levels are significantly associated with the development of postoperative pneumonia in patients undergoing major non-cardiac surgery. A preoperative albumin level of <45.3 g/L may serve as a predictive marker for postoperative pneumonia.
Keywords: Postoperative pneumonia, albumin, Non-cardiac surgery, dose-response, Restricted cubic spline
Received: 07 Jun 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Pang, Feng, Yang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qian-Yun Pang, pqy047417@163.com
Hong-Liang Liu, liuhl75@163.com
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