ObjectiveTo explore the clinical effects of exogenous glutamine on patients suffering from sepsis with hypoalbuminemia in emergency department. MethodsEighty-six patients with sepsis and hypoalbuminemia enrolled from January to November 2013 in the Emergency Department of our hospital were randomly divided into treatment group and control group. Forty-three patients in the control group were given conventional treatments, while the other 43 in the treatment group were treated with glutamine therapy based on the conventional treatments. The clinical efficacy of the two groups including inflammatory markers, albumin level, APACHEⅡ score and SAPSⅡ score, mortality, length of hospital stay were analyzed on day 7, 14, and 28 after being enrolled. A comprehensive analysis of the clinical effects in these two groups was performed. ResultsEighty-six cases were enrolled in this study. The mortality on day 14 and 28 in the treatment group was significantly lower than that in the control group (P<0.05). Inflammatory markers (WBC count, CRP concentration, and PCT concentration) in patients of the treatment group were gradually decreased, whereas serum albumin levels were gradually increased compared with the control group (P<0.05). The cure rate of patients in the treatment group was significantly higher than that in the control group, while the average length of stay was shorter than the control group (P<0.05) on day 28. ConclusionExogenous glutamine supplementation can improve patient cure rates and reduce hospital stays which has good clinical effects on patients with sepsis and hypoalbuminemia in emergency department.
Objective To investigate the risk factors of hypoproteinemia after laparoscopic assisted radical gastrectomy for gastric cancer and its influence on recent clinical outcome. Methods Retrospective case-control study was carried out. Clinical data of 135 patients underwent laparoscopic assisted radical gastrectomy for gastric cancer admitted to the Department of General Surgery in the First Affiliated Hospital of Xi’an Jiaotong University Medical College from June 2016 to June 2021 were collected. Postoperative hypoproteinemia was defined as serum albumin <30 g/Lon postoperative day 1. Observation indications: ① the incidence of hypoproteinemia after laparoscopic assisted radical gastrectomy for gastric cancer; ② analysis of risk factors for postoperative hypoproteinemia; ③ influence of postoperative hypoproteinemia on recent clinical outcome. Results ① Among 135 patients, 56 patients developed hypoproteinemia after operation (hypoproteinemia group) with an incidence of 41.5%, 79 patients without hypoproteinemia (non- hypoproteinemia group). ② Univariate analysis of risk factors for postoperative hypoproteinemia showed that age, preoperative albumin level, preoperative plasma volume, preoperative leukocyte, preoperative hemoglobin level, maximum tumor diameter, net intake on operative day and operative time were related to the occurrence of postoperative hypoproteinemia (P<0.05). The results of multivariate analysis showed that: age ≥65 years [OR=6.320, 95%CI (2.340, 17.068), P＜0.001], preoperative albumin level <35 g/L [OR=5.951, 95%CI (1.815, 19.507), P=0.003], operative time ≥5 h [OR=3.171, 95%CI (1.164, 8.640), P=0.024], and net intake on operative day ≥3 000 mL [OR=5.153, 95%CI (1.616, 16.432), P=0.006] were risk factors for postoperative hypoproteinemia. ③ Within 30 days after operation, the incidence of non surgery related complications in the hypoproteinemia group and the non-hypoproteinemia group were 30.4% (17/56) and 13.9% (11/79), respectively, and the incidence of surgery related complications were 10.7% (6/56) and 1.3% (1/79), respectively, with statistically significant differences (P<0.05). Conclusions Age ≥65 years, preoperative albumin level <35 g/L, operative time ≥5 h and net intake on operative day ≥3 000 mL are risk factors for hypoproteinemia after laparoscopic assisted radical gastrectomy. For patients suffered from hypoproteinemia (albumin <30 g/L) after surgery, the incidences of both surgery-related complications and non-surgery-related complications increase.
ObjectiveTo analyze the effects of preoperative protein level on the survival prognosis of patients underwent colorectal cancer (CRC) surgery in the current Database from Colorectal Cancer (DACCA). MethodsAccording to the established screening criteria, the patient information was extracted from the updated version of DACCA on November 24, 2024. The survival curves of the patients with and without preoperative hypoproteinemia were plotted by Kaplan-Meier method and the log-rank test was used to compare. The univariate and multivariate Cox regression analysis were used to analyze the preoperative hypoproteinemia affecting postoperative survival (overall survival and disease-specific survival) of patients with CRC. The test level was α=0.05. ResultsA total of 1 217 patients with CRC were included, and 252 of 1 217 patients with preoperative hypoproteinemia, with an incidence of 20.7%. The survival curves showed that the overall survival and disease-specific survival of the patients with preoperative hypoproteinemia were worse than those without preoperative hypoproteinemia (χ2=43.411, P<0.001; χ2=41.171, P<0.001). However, the multivariate Cox regression analysis did not find that the preoperative hypoproteinemia was a risk factor for postoperative survival (overall survival and disease-specific survival as observed indicators) in the patients with CRC [overall survival: HR (95%CI)=1.013 (0.741, 1.385), P=0.938; disease-specific survival: HR (95%CI)=1.003 (0.719, 1.399), P=0.987]. ConclusionThe results of this study suggest that the incidence rate of preoperative hypoproteinemia in patients with CRC is higher, and the survival prognosis is worse than that in patients without preoperative hypoproteinemia.