Sources of Variation in Hospital-Level Infection Rates After Coronary Artery Bypass Grafting: An Analysis of The Society of Thoracic Surgeons Adult Heart Surgery Database

The Annals of Thoracic Surgery
Donald S LikoskyMichigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative

Abstract

Patients undergoing coronary artery bypass grafting (CABG) are at risk for a variety of infections. Investigators have focused on predictors of these adverse sequelae, but less attention has been focused on characterizing hospital-level variability in these outcomes. Between July 2011 and December 2013, The Society of Thoracic Surgeons Adult Cardiac Surgery Database shows 365,686 patients underwent isolated CABG in 1,084 hospitals. Hospital-acquired infections (HAIs) were defined as pneumonia, sepsis/septicemia, deep sternal wound infection/mediastinitis, vein harvest/cannulation site infection, or thoracotomy infection. Hospitals were ranked by their HAI rate as low (≤ 10th percentile), medium (10th to 90th percentile), and high (>90th percentile). Differences in perioperative factors and composite morbidity and mortality end points across these groups were determined using the Wilcoxon rank sum and χ(2) tests. HAIs occurred among 3.97% of patients overall, but rates varied across hospital groups (low: <0.84%, medium: 0.84% to 8.41%, high: >8.41%). Pneumonia (2.98%) was the most common HAI, followed by sepsis/septicemia (0.84%). Patients at high-rate hospitals more often smoked, had diabetes, chronic lung disease, New York Hea...Continue Reading

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References

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Citations

Jun 5, 2016·The Annals of Thoracic Surgery·Raymond J StrobelUNKNOWN Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative
Jun 6, 2016·The Annals of Thoracic Surgery·Vinay BadhwarFred H Edwards
Nov 24, 2017·Journal of Cardiac Surgery·Alejandro Suarez-PierreJennifer S Lawton
Dec 21, 2018·Circulation. Cardiovascular Quality and Outcomes·Donald S LikoskyRichard L Prager
Mar 20, 2019·Acta Anaesthesiologica Scandinavica·Edda VesteinsdottirSigurbergur Karason
Jul 11, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Massimo ManconeUNKNOWN Collaborators
Mar 12, 2019·Annals of the Royal College of Surgeons of England·G SoppaM Jahangiri
Oct 26, 2018·Circulation. Cardiovascular Quality and Outcomes·Michael P ThompsonDonald S Likosky
Apr 18, 2017·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Chao-Feng LinLi-Nien Chien
Nov 13, 2020·Circulation. Cardiovascular Quality and Outcomes·Alexander A BresciaUNKNOWN Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (MSTCVS-QC) and the Michigan Value Collaborat
Jan 9, 2021·JMIR Research Protocols·Donald LikoskyMilisa M Manojlovich
Feb 10, 2020·The Annals of Thoracic Surgery·Raymond J StrobelUNKNOWN Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative
Feb 3, 2020·The Journal of Thoracic and Cardiovascular Surgery·Benjamin R GriffinMuhammad Aftab
Oct 3, 2018·The Annals of Thoracic Surgery·A Laurie W ShroyerBrack Hattler
Jun 9, 2021·The Journal of Thoracic and Cardiovascular Surgery·Donald S LikoskyUNKNOWN Michigan Congestive Heart Failure Investigators
Jul 5, 2021·The Journal of Thoracic and Cardiovascular Surgery·Walker M Blanding, Arman Kilic
Aug 21, 2021·ClinicoEconomics and Outcomes Research : CEOR·Rhodri Saunders, Amanda Hansson Hedblom
Apr 22, 2021·The Annals of Thoracic Surgery·Joseph HadayaPeyman Benharash
Oct 31, 2021·Journal of Cardiac Surgery·Giorgia BonalumiAlessandro Parolari

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