Perioperative evaluation of nutritional status to predict complications in patients with major lower extremity amputation.

Introduction: Optimization of nutritional status is critical in postoperative wound healing. Perioperative Alb and pAlb levels have been used as proxies for overall nutritional status.

Objective: This study examines if such biomarkers correlate with postoperative complications after MLEA for chronic wounds.

Materials And Methods: A retrospective review of patients undergoing MLEA at a single institution from January 2017 through October 2021 was performed. Data collection included demographics, comorbidities, and perioperative laboratory values. The primary outcomes were surgical dehiscence, hematoma, and infection within 30 days of surgery.

Results: A total of 303 patients undergoing MLEA met the inclusion criteria. At the threshold of less than 3.2 g/dL for low Alb, no significance was found for any postoperative complications. The threshold of less than 10 mg/dL for low pAlb was associated with significantly increased infection rates. At the threshold of less than 9 mg/dL for low pAlb, hematoma and infection were significantly increased compared with the defined normal perioperative pAlb. Alternatively, low Alb (<3.2 g/dL) did not correlate with postoperative complications.

Conclusions: Further investigation of validated biomarkers and their thresholds is needed to guide perioperative optimization of nutritional status after MLEA for chronic wounds.