Microalbuminuria as predictor of outcome after major abdominal surgery        ZHU Guo-chao, LI Rong，QUAN Zhuo-yong，et al.Department of Surgery , the Affiliated Hospital of Jianghan University, Wuhan 430015,China
Corresponding author : LI Rong，E-mail: rongman@163.com
Abstract    Objective    To evaluate microalbuminuria as predictor of outcome after major abdominal surgery.  Methods  Microalbuminuria (ACR) was measured in 48 hours post-operation and arterial lactate, PaO2/FiO2 ratio at ICU admission. Receiver-operator curves (ROC) were constructed to compare ACR, physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) score, LAC and PaO2/FiO2 ratio to predict outcome. Results    A total of 13 postoperative complications were recorded in 118 patients (11%). ACR at ICU admission and 6, 12, 18, 24 and 48 hours at ICU was significantly higher in patients with postoperative complications than in those without complications （P≤0.001）. ACR at 24 and 48 hours were positively correlated with POSSUM （r=0.374, P＜0.001，r=0.390, P＜0.001）、LAC（r=0.381, P<0.001，r=0.296, P=0.001）and LAC （r=0.381, P<0.001，r=0.296, P=0.001）and inversely correlated with mean PaO2/FiO2（r=-0.27, P=0.003，r=-0.251, P=0.006). The area of ROC of ACR at ICU 24, 48 hour and POSSUM to morbidity was statistically higher than 0.5 (0.857 vs 0.946 vs 0.89). Using a cutoff for ACR at ICU 24 hour of 5.0g/mol. The sensitivity for complication was 86.7%, with specificity of 33.3% and the positive predictive value of death was 16.9%, with negative predictive value of 94.1%. Conclusion    ACR is a valuable predictor of in-hospital outcome after major abdominal surgery.