ArticleThe Annals of thoracic surgery2015
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.
Article in The Annals of thoracic surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02068716 (Optimizing Prevention of Healthcare-Acquired Infections After Cardiac Surgery), which is not on this map. Cited by 24 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Optimizing Prevention of Healthcare-Acquired Infections After Cardiac Surgery
Who cites it
24 citing papers in PubMed, 36 citations in OpenAlex.
- Interhospital variation in Medicare spending for infections after coronary artery bypass grafting and surgical aortic valve replacement.JTCVS open · 2026Article
- Trends and Impact ofGastroenterology research · 2026Article
- Interhospital variability in 180-day infections following cardiac surgery.The Journal of thoracic and cardiovascular surgery · 2025Article
- Disparities in 180-day infection rates following coronary artery bypass grafting and aortic valve replacement.The Journal of thoracic and cardiovascular surgery · 2025Article
- Multicenter Analysis of the Relationship Between Operative Team Familiarity and Safety and Efficiency Outcomes in Cardiac Surgery.Circulation. Cardiovascular quality and outcomes · 2024Article
- Outcomes of nonemergency cardiac surgery after overnight operative workload: A statewide experience.JTCVS open · 2024Article
- Interhospital variability in health care-associated infections and payments after durable ventricular assist device implant among Medicare beneficiaries.The Journal of thoracic and cardiovascular surgery · 2022Article
- A Retrospective Study of the Relationship Between Blood Transfusion and 30-Day Postoperative Outcomes in Patients Undergoing Isolated Off-Pump Coronary Artery Bypass Grafting.Brazilian journal of cardiovascular surgery · 2022Article
- Observational
- Prognostic value of SARS-CoV-2 on patients undergoing cardiac surgery.Journal of cardiac surgery · 2022Article
- Impact of preoperative nasopharyngeal cultures on surgical site infection after open heart surgery.JTCVS open · 2021Article
- Plasma and Lung Tissue Pharmacokinetics of Ceftaroline Fosamil in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass: anAntimicrobial agents and chemotherapy · 2021Article
- Stage 1 acute kidney injury is independently associated with infection following cardiac surgery.The Journal of thoracic and cardiovascular surgery · 2021Article
- Novel Assessments of Technical and Nontechnical Cardiac Surgery Quality: Protocol for a Mixed Methods Study.JMIR research protocols · 2021Article
- The Economic Implications of Introducing Single-Patient ECG Systems for Cardiac Surgery in Australia.ClinicoEconomics and outcomes research : CEOR · 2021Article
- Determinants of Value in Coronary Artery Bypass Grafting.Circulation. Cardiovascular quality and outcomes · 2020Article
- Evaluating the Impact of Pneumonia Prevention Recommendations After Cardiac Surgery.The Annals of thoracic surgery · 2020Article
- Hospital Variability Drives Inconsistency in Antiplatelet Use After Coronary Bypass.The Annals of thoracic surgery · 2020Article
- Infections and outcomes after cardiac surgery-The impact of outbreaks traced to transesophageal echocardiography probes.Acta anaesthesiologica Scandinavica · 2019Observational
- Variation between hospitals in outcomes following cardiac surgery in the UK.Annals of the Royal College of Surgeons of England · 2019Article
Corrections and comments
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Authors and funding
13 authors at 8 institutions in 1 country.
Funding
Abstract
backgroundPatients 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.
methodsBetween 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.
resultsHAIs 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 Heart Association Functional Classification III to IV, and received blood products (p < 0.001); however, they less often were prescribed the appropriate antibiotics (p < 0.001). Major morbidity and mortality occurred among 12.3% of patients, although this varied by hospital group (low: 8.6%, medium: 12.3%, high: 17.9%; p < 0.001).
conclusionsSubstantial hospital-level variation exists in postoperative HAIs among patients undergoing CABG, driven predominantly by pneumonia. Given the relatively small absolute differences in comorbidities across hospital groups, our findings suggest factors other than case mix may explain the observed variation in HAI rates.
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