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Post-CABG infection rates vary widely in Michigan
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The rate of health care-acquired infections after CABG varied substantially across 33 hospitals in Michigan, new data suggest.
Researchers evaluated the incidence of health care-acquired infections among 20,896 adults who underwent isolated CABG within the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (MSTCVS-QC), a collection of 33 hospitals in Michigan, from 2009 to June 30, 2012. Assessed infections included pneumonia, sepsis/septicemia and surgical site infections.
Across the cohort, the overall health care-acquired infection rate was 5.1%. This included isolated pneumonia (3.1%), isolated sepsis/septicemia (0.5%), isolated deep sternal wound infection (0.5%), isolated harvest/cannulation site infection (0.5%), isolated thoracotomy (0.02%) and multiple infections (0.6%). Researchers predicted via multivariable logistic regression that the risk for infection would differ by 2.8% across evaluated centers, but the observed range was 18.2% after adjustment for confounders.
Infections that occurred at facilities with low overall rates (<4.5%; n=14 hospitals) most commonly included isolated pneumonia (49% of cases), isolated harvest/cannulation site infection (17%) and isolated deep sternal wound infection (12%). At centers with higher overall rates (≥7%; n=4 hospitals), the most common infections were isolated pneumonia (70%), multiple infections (14%) and sepsis/septicemia (10%).
“We demonstrate large variation in [health care-acquired infection] rates after cardiac surgery across all 33 hospitals participating in the MSTCVS-QC, even after adjustment,” the researchers wrote. “The observed variation is largely because of rates of pneumonia and multiple infections across centers. We hypothesize that efforts to reduce this variation should focus on developing and supporting multidisciplinary clinical care teams across traditional silos of care.”
Disclosure: The researchers report no relevant financial disclosures.
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