Comment On: Hypoalbuminemia As a Risk Factor for Complications in Revisional/conversional Bariatric Surgery: an MBSAQIP Analysis.

It has been known for a while that malnutrition, similar to frailty, is a preoperative risk factor for infections, anastomotic failures, and all sorts of complications. I used to say to our residents and fellows that when a bariatric patient comes in with severe malnutrition after a complicated primary bariatric operation (like a stricture after sleeve or gastric bypass) or severe hypo-absorption after duodenal switch, we have to nutritionally replenish these patients until normal parameters are reached before attempting a revision or conversion; this is common sense. I read with interest the article entitled “Hypoalbuminemia as a Risk Factor for Complications in Revisional/Conversional Bariatric Surgery: an MBSAQIP Analysis” by Perez et al. [ [1] Perez S.C. Alessi I.G. Wheeler A.A. Hypoalbuminemia as a risk factor for complications in revisional/conversional bariatric surgery: an MBSAQIP analysis. Surg Obes Relat Dis. 2023; 19: 555-562 Abstract Full Text Full Text PDF Google Scholar ]. In their study, after thorough review of 58,777 patients accessible for analysis, hypoalbuminemia had a significantly greater risk of postoperative complications associated with elective bariatric surgery, demanding blood transfusion (3.1% versus 1.27%; P < .001), 30-day readmission (10.87 versus 6.77%; P < .001), 30-day reoperation (4.9% versus 3.18%; P < .001), and 30-day mortality (.40% versus .14%; P < .0001) [ [1] Perez S.C. Alessi I.G. Wheeler A.A. Hypoalbuminemia as a risk factor for complications in revisional/conversional bariatric surgery: an MBSAQIP analysis. Surg Obes Relat Dis. 2023; 19: 555-562 Abstract Full Text Full Text PDF Google Scholar ]. Hypoalbuminemia as a risk factor for complications in revisional/conversional bariatric surgery: an MBSAQIP analysisSurgery for Obesity and Related DiseasesVol. 19Issue 6PreviewHypoalbuminemia (HA) is a risk factor for serious complications after elective bariatric surgery. Patients undergoing revisional/conversional bariatric surgery may represent a higher-risk group who often have underlying co-morbid medical illnesses and more complex surgery. Full-Text PDF