Hypoalbuminaemia in orthopaedic trauma patients in a rural hospital in South Africa

• Published in: International orthopaedics Vol. 46; no. 1; pp. 37 - 42
• Main Authors: Maimin, D. G., Laubscher, M., Maqungo, S., Marais, L. C.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 2022
• Subjects: Cross-Sectional Studies; Hospitals, Rural; Humans; Hypoalbuminemia - complications; Medicine; Medicine & Public Health; Original Paper; Orthopedics; Retrospective Studies; South Africa - epidemiology; South Africa; Rural; Global Surgery; Albumin; Hypoalbuminaemia; Trauma; Orthopaedics
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-021-05022-4

Background The deleterious effects of hypoalbuminaemia in the peri-operative period are well documented. We aimed to review serum albumin levels in a cohort of orthopaedic trauma patients to determine the prevalence of hypoalbuminaemia. Secondarily, we aimed to identify factors associated with an increased risk of hypoalbuminaemia. Methods A retrospective cross-sectional study was performed of data collected prospectively at a regional hospital serving primarily a rural population in South Africa. Results Two hundred ninety-five patients were included in the study. Twenty-nine per cent of the cohort was found to have hypoalbuminaemia. Femur neck fractures ( p < 0.001), intertrochanteric fractures ( p = 0.004), tibial plateau fractures ( p = 0.034) and polytrauma ( p = 0.013) were associated with hypoalbuminaemia. The mean albumin level was lower in HIV-positive patients when compared to HIV-negative patients (35.7 g/L vs 37.5 g/L, p = 0.007). The presence of comorbidities other than HIV, like diabetes mellitus ( p = 0.001), previous pulmonary tuberculosis ( p = 0.034) and chronic renal failure ( p = 0.007) was associated with hypoalbuminaemia. Conclusion In this cohort of orthopaedic trauma patients from rural South Africa, we found a 29% prevalence of hypoalbuminaemia at the time of presentation. High-risk subgroups include patients with pre-existing comorbidities and increased age, as well as patients presenting with polytrauma, femoral neck, intertrochanteric femur or tibial plateau fractures.