Old and new nutritional markers in colorectal surgery: the role of albumin and vitamin D in predicting postoperative complications

Background: The role of 25-hydroxy vitamin D (25(OH)D) in predicting surgical complications has been increasingly studied in various fields, with limited research on its impact in colorectal surgery. This study aimed to assess the predictive value of preoperative vitamin D levels for postoperative complications and compare it with albumin levels, a known nutritional marker. The secondary objective was to identify cutoff values for both markers to identify at-risk patients for targeted nutritional interventions. Methods: This single-center, retrospective study included patients undergoing colorectal surgery between June 2023 and August 2024. Preoperative 25(OH)D, albumin, and other nutritional markers (blood glucose, folate, vitamin B12) were measured during a nutritional assessment one month before surgery. These markers were analyzed in relation to postoperative complications. Results: Lower preoperative levels of both 25(OH)D and albumin were significantly associated with postoperative complications (P=0.039 and P=0.012, respectively). Univariate analysis identified ASA score, folate, 25(OH)D, and albumin as predictors, with multivariate analysis confirming albumin (P=0.044) as significant, while 25(OH)D showed a trend (P=0.086). Optimal cutoff values were 14.4 ng/mL for 25(OH)D and 3.6 g/dL for albumin. Conclusions: Lower 25(OH)D and albumin levels were associated with postoperative complications. Preoperative nutritional assessment is critical for identifying high-risk patients and implementing corrective interventions.