Abstract
OBJECTIVE: This review aimed to assess whether hypoalbuminaemia can predict postoperative pulmonary complications (PPCs) and mortality in patients receiving general anaesthesia for surgery. METHODS: PubMed, Web of Science, EMBASE, and the Cochrane Library were searched for relevant articles published up to 18 July 2024. Three authors independently reviewed the studies and assessed the quality of related articles via the Newcastle‒Ottawa Scale. The data were recorded, and a meta-analysis was performed using Review Manager version 5.4.1. RESULTS: A total of 40 studies with 477,701 patients were included in the meta-analysis. Adjusted data were pooled to calculate the odds ratio (OR). A sensitivity test was conducted. A meta-analysis of 18 studies demonstrated that hypoalbuminaemia was a significant predictor of PPCs and mortality after general anaesthesia (OR: 2.88, 95% CI 2.50 to 3.32, P < 0.01, I(2) = 90%). The 40 studies were divided into 4 groups based on surgical site: the orthopaedic surgery group (OR: 4.03, 95% CI 3.49 to 4.64, P < 0.01, I(2) = 43%), the thoracic surgery group (OR: 1.82, 95% CI 1.46 to 2.26, P < 0.01, I(2) = 23%), the abdominal surgery group (OR: 2.48, 95% CI 1.81 to 3.40, P < 0.01, I(2) = 95%) and the other surgery group (OR: 2.34, 95% CI 1.66 to 3.29, P < 0.01, I(2) = 87%). In addition, patients with hypoalbuminaemia had increased mortality (OR: 4.31, 95% CI 4.124.51, P, I(2) = 68%). CONCLUSIONS: Preoperative hypoalbuminaemia is significantly associated with postoperative pulmonary complications and has different correlation coefficients in different types of surgeries. TRIAL REGISTRATION: This systematic review and meta-analysis was registered at the International Prospective Register of Systematic Reviews (Number CRD42024540493).