Surgical-Site Infection Rates and Risk Factor Analysis in Coronary Artery Bypass Graft Surgery

2004 ◽  
Vol 25 (6) ◽  
pp. 472-476 ◽  
Author(s):  
Glenys Harrington ◽  
Philip Russo ◽  
Denis Spelman ◽  
Sue Borrell ◽  
Kerrie Watson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Factor Analysis ◽  
Risk Factor ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Public Hospitals ◽  
Site Infection ◽  
Artery Bypass Graft ◽  
Cabg Surgery

AbstractBackground:The Victorian Infection Control Surveillance Project (VICSP) is a multicenter collaborative surveillance project established by infection control practitioners. Five public hospitals contributed data for patients undergoing coronary artery bypass graft (CABG) surgery.Objective:To determine the aggregate and comparative interhospital surgical-site infection (SSI) rates for patients undergoing CABG surgery and the risk factors for SSI in this patient group.Method:Each institution used standardized definitions of SSI, risk adjustment, and reporting methodology according to the National Nosocomial Infections Surveillance System of the Centers for Disease Control and Prevention. Data on potential risk factors were prospectively collected.Results:For 4,474 patients undergoing CABG surgery, the aggregate SSI rate was 7.8 infections per 100 procedures (95% confidence interval [CI95], 7.0-8.5), with individual institutions ranging between 4.5 and 10.7 infections per 100 procedures. Multivariate risk factor analysis demonstrated age (odds ratio [OR], 1.02; CI95, 1.01-1.04; P < .001), obesity (OR, 1.8; CI95, 1.4-2.3; P < .001), and diabetes mellitus (OR, 1.6; CI95, 1.2-2.1; P < .001) as independent predictors of SSI. Three hundred thirty-four organisms were isolated from 296 SSIs. Of the total SSIs, methicillin-resistant Staphylococcus aureus was isolated from 32%, methicillin-sensitive S. aureus from 24%, gram-negative bacilli (eg, Enterobacter and Escherichia colt) from 18%, and miscellaneous organisms from the remainder.Conclusion:We documented aggregate and comparative SSI rates among five Victorian public hospitals performing CABG surgery and defined specific independent risk factors for SSI. VICSP data offer opportunities for targeted interventions to reduce SSI following cardiac surgery.

Risk Factors for Radial Artery Harvest Site Infection Following Coronary Artery Bypass Graft Surgery

2000 ◽  
Vol 30 (2) ◽  
pp. 270-275 ◽  
Author(s):  
William E. Trick ◽  
William E. Scheckler ◽  
Jerome I. Tokars ◽  
Kevin C. Jones ◽  
Ellen M. Smith ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Radial Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Site Infection ◽  
Artery Bypass Graft ◽  
Harvest Site

scholarly journals The Prevalence of Risk Factors for Coronary Artery Disease in Post Coronary Artery Bypass Graft Patients

KYAMC Journal ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 9-13
Author(s):  
Siba Pada Roy ◽  
Pradip Kumar Sarker ◽  
Ibrahim Khalilullah ◽  
Ahsan Habibur Rahman ◽  
Sutapa Sarker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Family History ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft

Background: Cardiovascular diseases, the part of non communicable diseases are the 30% death in Bangladesh. Many patients undergoing coronary artery bypass graft surgery have previous cardiovascular risk factors which could be prevented. Objectives: To assess the prevalence of cardiovascular risk factors in the patients undergoing coronary artery bypass graft surgery. Materials and Methods: All patients who had coronary artery bypass grafting between January 2018 to June 2018 data were collected retrospectively in six month duration time at a tertiary cardiac care hospital in Dhaka, Bangladesh. The prevalence rate of conventional risk factors are presented for observational study. Results: Out of 305 patients, 251 (82.3%) were male and 54 (17.7%) were female. The age ranged from 31 to 78 years old. The mean age was(56.72 ± 3.6). Hypertension was present in 249 (81.6% ),diabetes 211 (69.2%), Dyslipidemia had 200 ( 65.6% ), smoking habits had 105 (34.4%) and strong family history 9 (3%). As far as the obesity was concern 149 (48.9%)normal weight,128 (42.0%) patients were overweight and 25(8.2%) were obese. Majority of the patients had 3 risk factors together 136(44.6%), 2 risk factors 82 (26.9%), 1 risk factor 41(13.4%), 4 risk factors 38(12.5%) and 8(2.6%) had no risk factors. As compared to using the bypass technique there were 242(79.4%) On pump arrest heart, 40(13.1%) by On pump beating and 23(7.5%) were by Off pump beating. Mortality was 2.3%.Out of them 3(42.86%) patients had 3 risk factors, 2 (28.57%) patients had 2 risk factors and 2(28.57%) patients had 1 risk factor. Conclusion: The most common risk factors were hypertension, followed by diabetes, dyslipidemia , male gender, smoking, obesity and positive family history. These patients are recommended to be trained regarding lifestyle changes. Also, prevention strategies can play an important role in reducing patients' morbidity and mortality. KYAMC Journal Vol. 11, No.-1, April 2020, Page 9-13

Validation of Coronary Artery Bypass Graft Surgical Site Infection Surveillance Data From a Statewide Surveillance System in Australia

2007 ◽  
Vol 28 (7) ◽  
pp. 812-817 ◽  
Author(s):  
N. Deborah Friedman ◽  
Philip L. Russo ◽  
Ann L. Bull ◽  
Michael J. Richards ◽  
Heath Kelly
Keyword(s):  
Coronary Artery ◽  
Medical Records ◽  
Surveillance System ◽  
Artery Bypass ◽  
Donor Site ◽  
Bypass Graft ◽  
Site Infection ◽  
Artery Bypass Graft ◽  
Cabg Surgery ◽  
Infection Surveillance

Objective.To measure the accuracy and determine the positive predictive value (PPV) and negative predictive value (NPV) of data submitted to a statewide surveillance system for identifying surgical site infection (SSI) complicating coronary artery bypass graft (CABG) surgery.Design.Retrospective review of hospital medical records comparing SSI data with surveillance data submitted by infection control consultants (ICCs).Setting.Victorian Hospital Acquired Infection Surveillance System (VICNISS) Coordinating Centre in Victoria, Australia.Patients.All patients reported to have an SSI following CABG surgery and a random sample of approximately 10% of patients reported not to have an SSI following CABG surgery.Results.The VICNISS ascertainment rate for CABG procedures in Victoria was 95%. One hundred sixty-nine medical records were reviewed, and reviewers agreed with ICCs about 46 (96%) of the patients reported as infected by the ICCs and 31 (91%) of the patients identified with a sternal SSI by the ICCs. In one-third of SSIs, the depth of SSI documented by ICCs was discordant with that documented by the reviewers. Disagreement about patients with donor site SSI was frequent. When the review findings were used as the reference standard, the PPV for ICC-reported SSI was 96% (95% confidence interval [CI], 86%-99%), and the NPV was 97% (95% CI, 92%-99%). For ICC-reported sternal SSI, the PPV was 91% (95% CI, 76%-98%) and the NPV was 98% (95% CI, 94%-100%).Conclusions.There was broad agreement on the number of infected patients and the number of patients with sternal SSI. However, discordance was frequent with respect to the depth of sternal SSI and the identification of donor site SSI. We recommend modifications to the methodology for National Noscomial Infection Surveillance System-based surveillance for SSI following CABG surgery.

Multivariate risk factor analysis of clinical outcome 15 years after venous coronary artery bypass graft surgery

1995 ◽  
Vol 16 (9) ◽  
pp. 1200-1206 ◽  
Author(s):  
B. L. VAN BRUSSEL ◽  
H. W. M. PLOKKER ◽  
A. A. VOORS ◽  
J. M. P. G. ERNST ◽  
N. M. ERNST ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Risk Factor ◽  
Coronary Artery ◽  
Clinical Outcome ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Multivariate Risk

scholarly journals Increased Peak Postoperative B-type Natriuretic Peptide Predicts Decreased Longer-term Physical Function after Primary Coronary Artery Bypass Graft Surgery

2011 ◽  
Vol 114 (4) ◽  
pp. 807-816 ◽  
Author(s):  
Amanda A. Fox ◽  
Edward R. Marcantonio ◽  
Charles D. Collard ◽  
Mathis Thoma ◽  
Tjorvi E. Perry ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Short Form ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Effect Estimate ◽  
Artery Bypass Graft ◽  
Cabg Surgery ◽  
Short Form 36

Background Increased peak postoperative B-type natriuretic peptide (BNP) is associated with increased major adverse cardiovascular events and all-cause mortality after coronary artery bypass graft (CABG) surgery. Whether increased postoperative BNP predicts worse postdischarge physical function (PF) is unknown. We hypothesized that peak postoperative BNP associates with PF assessed up to 2 yr after CABG surgery, even after adjusting for clinical risk factors. including preoperative PF. Methods This two-institution prospective cohort study included patients undergoing primary CABG surgery with cardiopulmonary bypass. Short Form-36 questionnaires were administered to subjects preoperatively and 6 months, 1 yr, and 2 yr postoperatively. Short Form-36 PF domain scores were calculated using the Short Form-36 norm-based scoring algorithm. Plasma BNP concentrations measured preoperatively and on postoperative days 1-5 were log(10) transformed before analysis. To determine whether peak postoperative BNP independently predicts PF scores 6 months through 2 yr after CABG surgery, multivariable longitudinal regression analysis of the postoperative PF scores was performed, adjusting for important clinical risk factors. Results A total of 845 subjects (mean ± SD age, 65 ± 10 yr) were analyzed. Peak postoperative BNP was significantly associated with postoperative PF (effect estimate for log(10) peak BNP, -7.66 PF score points [95% CI, -9.68 to -5.64]; P = &lt;0.0001). After multivariable adjustments, peak postoperative BNP remained independently associated with postoperative PF (effect estimate for log(10) peak BNP, -3.06 PF score points [95% CI, -5.15 to -0.97]; P = 0.004). Conclusions Increased peak postoperative BNP independently associates with worse longer-term PF after primary CABG surgery. Future studies are needed to determine whether medical management targeted toward reducing increased postoperative BNP can improve PF after CABG surgery.

scholarly journals Prediction of Postoperative Pulmonary Complications on the Basis of Preoperative Risk Factors in Patients Who Had Undergone Coronary Artery Bypass Graft Surgery

2003 ◽  
Vol 83 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Erik HJ Hulzebos ◽  
Nico LU Van Meeteren ◽  
Rob A De Bie ◽  
Pieter C Dagnelie ◽  
Paul JM Helders
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Pulmonary Complications ◽  
Artery Bypass Graft ◽  
Postoperative Pulmonary Complications ◽  
Preoperative Risk ◽  
Cabg Surgery ◽  
Preoperative Risk Factors

Abstract Background and Purpose. Pulmonary complications are among the most frequently reported complications after coronary artery bypass graft (CABG) surgery. However, the risks of postoperative pulmonary complications (PPCs) are not equal for all patients. The aim of this study was to develop a model, based on preoperative factors, for classifying patients with high and low risks for PPCs in order to implement tailored interventions. Subjects and Methods. Postoperative pulmonary complications were examined in 117 adult patients who had undergone elective CABG surgery at the University Medical Centre Utrecht, Utrecht, the Netherlands. The presence of preoperative risk factors (N=12) that have been described in the literature was noted for each patient. A risk model was developed by use of logistic regression analysis. Results. Preoperative risk factors for developing PPCs were an age of ≥70 years, productive cough, diabetes mellitus, and a history of cigarette smoking. Protective factors against the development of PPCs were a predicted inspiratory vital capacity of ≥75% and a predicted maximal expiratory pressure of ≥75%. These risk and protective factors were included in the model (sensitivity=87% and specificity=56%), and a sum score for its clinical use was generated. Discussion and Conclusion. Six factors that can be determined easily before surgery, with need for only simple pulmonary testing, can provide a model for identifying patients at risk of developing PPCs after CABG surgery.

Risk factors for postoperative pulmonary complications in coronary artery bypass graft surgery patients

2007 ◽  
Vol 6 (3) ◽  
pp. 241-246 ◽  
Author(s):  
Louise Jensen ◽  
Liyan Yang
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Pleural Effusion ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Pulmonary Complications ◽  
Artery Bypass Graft ◽  
Postoperative Pulmonary Complications ◽  
Cabg Surgery ◽  
History Of

Background Despite numerous advances in anesthesia, surgical techniques, and postoperative care for coronary artery bypass graft (CABG) surgery, postoperative pulmonary complications (PPCs) still account for postoperative morbidity. Objective To determine current risk factors for PPCs in CABG surgery patients. Methods A retrospective cohort design was used. Health records were reviewed for patients ( n=315) who had CABG surgery at a large quaternary healthcare center over a 4 month period. Pre-, peri-, and postoperative risk factors for PPCs were recorded as binary variables. Data were further assessed according to PPCs and non-PPCs using logistic regression models. Results PPCs occurred in 99.4% of this CABG surgical cohort. Atelectasis, pleural effusion, atelectasis with pleural effusion, and pneumonia were the most frequent PPCs post CABG surgery. Age >65 years, diabetes, and ASA classification N3 were found to be related to the presence of atelectasis. No significant risk factors were related to the development of pleural effusion or atelectasis with pleural effusion. Postoperative pneumonia was associated with previous myocardial infarction, ventilation >10 h, and hospital stay >5 days. History of bronchitis and COPD were related to postoperative pneumothorax; history of heart failure, COPD, and other lung diseases were related to postoperative pulmonary edema. Conclusion These findings contribute to the understanding of PPCs in post-CABG surgery patients and assist in identification of patients at risk for developing PPCs.

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