Evidence map›Paper›PMID 37797934›Full record

Observational studyThe Journal of thoracic and cardiovascular surgery2024

The association of intraoperative and early postoperative events with risk of pneumonia following cardiac surgery.

Noah M Barnett, Daniel R Liesman, Raymond J Strobel, Xiaoting Wu, Gaetano Paone, Alphonse DeLucia, Min Zhang, Carol Ling, Francis D Pagani, Donald S Likosky and 1 more

Open access · greenAbstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Journal of thoracic and cardiovascular surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.9field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 13 citations in OpenAlex.

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  5. Interhospital variability in 180-day infections following cardiac surgery.The Journal of thoracic and cardiovascular surgery · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Noah M BarnettUniversity of Michigan Medical School, Ann Arbor, Mich.
Daniel R LiesmanDepartment of Surgery, Northwestern University, Chicago, Ill.
Raymond J StrobelDepartment of Surgery, University of Virginia, Charlottesville, Va.
Xiaoting WuDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Mich.
Gaetano PaoneDivision of Cardiothoracic Surgery, Emory Health, Atlanta, Ga.
Alphonse DeLuciaDepartment of Cardiac Surgery, Bronson Medical Center, Kalamazoo, Mich.
Min ZhangDepartment of Biostatistics, University of Michigan, Ann Arbor, Mich.
Carol LingDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Mich.
Francis D PaganiDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Mich.
Donald S LikoskyDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Mich. Electronic address: likosky@med.umich.edu.
Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative
University of Michigan–Ann Arbor · USBronson Methodist Hospital · USEmory Healthcare · USNorthwestern University · PHUniversity of Virginia · US

Funding

Cardiovascular Surgery Training ProgramT32HL007849 · NHLBI · UNIVERSITY OF VIRGINIA CHARLOTTESVILLE · PI KRON, IRVING L., LAUBACH, VICTOR E · 1998 to 2025
$7.0M
Network for Cardiothoracic Surgical Investigations in Cardiovascular MedicineUM1HL088925 · NHLBI · UNIVERSITY OF VIRGINIA · PI BADHWAR, VINAY, KRON, IRVING L. · 2013 to 2025
$6.8M
Understanding and Addressing Variation in Healthcare-Associated Infections After Adult Cardiac SurgeryR01HS029026 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LIKOSKY, DONALD S, PAGANI, FRANCIS D · 2022 to 2024
$1.4M
AHRQ HHS R01 HS029026NHLBI NIH HHS T32 HL007849NHLBI NIH HHS UM1 HL088925
6 · The paper itself

Abstract

backgroundPneumonia, the most common infection following cardiac surgery, is associated with major morbidity and mortality. Although prior work has identified preoperative risk factors for pneumonia, the present study evaluated the role and associated impact of intraoperative and postoperative risk factors on pneumonia after cardiac surgery.

methodsThis observational cohort study evaluated 71,165 patients undergoing coronary and/or aortic valve surgery across 33 institutions between 2011 and 2021. Terciles of estimated pneumonia risk were compared between a validated preoperative model (Model One) and a model additionally accounting for significant intraoperative (eg, bypass duration) and postoperative (eg, extubation time) factors (Model Two). Logistic regression was used to develop and validate Model Two.

resultsPostoperative pneumonia occurred in 2.62% of the patients. A total of 9 significant intraoperative and early postoperative risk factors were identified. The absolute risk of pneumonia increased across Model One terciles: low (≤1.04%), medium (1.04%-2.40%), and high (>2.40%). Model two performed well (c-statistic = 0.771). Most patients (60.1%) had no change in their preoperative versus intraoperative/postoperative risk tercile. The 19.6% of patients who increased their risk tercile with Model Two accounted for 18.6% of all pneumonia events.

conclusionsThis study identified 9 significant perioperative risk factors for pneumonia. Nearly 1 of every 5 patients moved into a higher pneumonia risk category based on their intraoperative and postoperative course. These findings may serve as the focus of future quality improvement efforts to reduce a patient's risk of postoperative pneumonia.

Indexed as

Cardiac Surgical ProceduresPneumoniaAgedFemaleHumansMaleMiddle AgedPostoperative ComplicationsRisk AssessmentRisk FactorsTime FactorsUnited Statescoronary artery bypass graftingoutcomespneumoniasurgical aortic valve replacement

Identifiers

PMID37797934
PMCPMC10991082
OpenAlexW4387335228

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.