Investigate preoperative blood biomarker differences for patients undergoing bilateral salpingo-oophorectomy (BSO) with and without postoperative sepsis.

Design:

Patients from the American College of Surgeons National Surgical Quality Improvement Project database from the years 2005 to 2019 were analyzed. All surgical patients undergoing any surgical procedure involving a BSO surgery, identified by identification of the term “BSO” in the principal operative procedure CPT code description, met the inclusion criteria. Sepsis was defined as an acute infectious process postoperatively presenting within 30 days immediately following a patient's primary BSO procedure.

Setting: N/A

Patients or Participants:

16,486 patients undergoing a BSO surgery were identified, of which 340 (2.06%) patients developed postoperative sepsis.

Interventions: N/A

Measurements and Main Results:

One-way analysis of variance (ANOVA) testing was conducted to obtain p-values. Multivariable logistic regression models were developed to calculate adjusted odds ratios (aOR) with 95% confidence intervals.

Preoperative white blood cell count (p=0.004), preoperative albumin (p<0.001), and preoperative creatinine (p=0.027) were all statistically significant predictors of postoperative sepsis in BSO patients. Preoperative sodium, blood urea nitrogen, bilirubin, serum glutamic-oxaloacetic transaminase, and alkaline phosphatase were not statistically significant predictors (p>0.05).

For BSO patients who developed postoperative sepsis, elevated preoperative white blood cell count AOR: 0.95 (95% CI: 0.92-0.99) and preoperative serum albumin AOR: 0.34 (95% CI: 0.28-0.41) were associated with increased odds for developing postoperative sepsis, while elevated preoperative serum creatinine was associated with decreased risk for developing postoperative sepsis AOR: 1.32 (95% CI: 1.03-1.68).

Conclusion:

Elevated preoperative concentrations of white blood cell count, albumin, and creatinine may be useful in earlier diagnosis and management of postoperative sepsis. Awareness of these preoperative indicators may help providers initiate tighter clinical management, closer followup, and pave the way for potential risk prediction models.