Does Categorization Method Matter in Exploring Volume-Outcome Relation? A Multiple Categorization Methods Comparison in Coronary Artery Bypass Graft Surgery Surgical Site Infection

2015 ◽  
Vol 16 (4) ◽  
pp. 466-472 ◽  
Author(s):  
Tsung-Hsien Yu ◽  
Yu-Chi Tung ◽  
Kuo-Piao Chung
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Surgical Site Infection ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Site Infection ◽  
Artery Bypass Graft ◽  
Methods Comparison ◽  
Volume Outcome

Retrospective analysis of the Photo at Discharge scheme and readmission for surgical site infection following coronary artery bypass graft surgery

2018 ◽  
Vol 19 (6) ◽  
pp. 270-276 ◽  
Author(s):  
Melissa Rochon ◽  
Sian Jenkinson ◽  
Reeshma Ramroop ◽  
Alexia Deakin ◽  
Padma Rai ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Surgical Site Infection ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Site Infection ◽  
Artery Bypass Graft ◽  
Post Discharge ◽  
Observation Study

Background: Surgical site infection (SSI) is a costly and devastating complication of surgery. Many cardiac SSIs develop after the patient leaves hospital, but evidence demonstrating the benefit of patient/carer involvement in the process of monitoring and promptly identifying SSI post-discharge is limited. This study estimates the probability of readmission for SSI for coronary artery bypass graft (CABG) patients receiving the Photo at Discharge (PaD). Methods: Trained personnel undertook continuous, prospective SSI surveillance using Public Health England protocol between January 2013 and December 2016. Baseline covariables were collected for 1747 CABG-only procedures. As a quasi-randomised design, we adjusted for non-random PaD assignment using retrospective propensity score (PS)-matching based on 12 variables of interest, assessed whether the model had been adequately specified and performed an outcomes analysis. Results: A total of 568 patients with PaD were PS-matched with 568 controls. The probabilities of SSI readmission were 0.352 (2/568) and 1.761 (10/568), respectively. The difference in risk of readmission for SSI was significant (relative risk = 0.2, 95% confidence interval = 0.04–0.91; P = 0.04). Conclusion: Findings from this single-centre observation study suggest the PaD is associated with a reduction in CABG readmission for SSI and a further study is warranted to verify the efficacy of this strategy.

The Relationship Between Surgical Site Infection and Volume of Coronary Artery Bypass Graft Surgeries: Taiwan Experience

2006 ◽  
Vol 27 (3) ◽  
pp. 308-311 ◽  
Author(s):  
Shiao-Chi Wu ◽  
Chi-Chen Chen ◽  
Yee-Yung Ng ◽  
Hui-Fan Chu
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Surgical Site Infection ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Site Infection ◽  
Surgical Volume ◽  
Artery Bypass Graft ◽  
The Relationship

In this study, the overall incidence of surgical site infection was 8.83% (3.28% for index hospitalization events [ie, events that occurred during hospitalization for surgery] and 5.55% for postdischarge events [ie, events that occurred within 30 days after discharge]). There was a negative association between surgical volume and the incidence of surgical site infection following coronary artery bypass graft surgery. The hospital volume has a greater effect than does surgeon volume on reducing the incidence of surgical site infection.

Sternal Surgical-Site Infection Following Coronary Artery Bypass Graft Prevalence, Microbiology, and Complications During a 42-Month Period

2004 ◽  
Vol 25 (6) ◽  
pp. 468-471 ◽  
Author(s):  
Mamta Sharma ◽  
Dorine Berriel-Cass ◽  
Joseph Baran
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Surgical Site Infection ◽  
Coronary Artery Bypass ◽  
Antimicrobial Prophylaxis ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Site Infection ◽  
Artery Bypass Graft ◽  
Gram Positive

AbstractObjective:Surgical-site infection (SSI) is a serious and costly complication following coronary artery bypass graft (CABG). We analyzed surgical factors, microbiology, and complications at a 608-bed community teaching hospital to identify opportunities for prevention.Methods:All patients undergoing CABG procedures from June 1997 through December 2000 were analyzed. Hospital records and postdischarge surveillance data were reviewed for demographics, surgical information, timing and classification of infection, microbiology, and bacteremic events.Results:Of 3,443 patients undergoing CABG, sternal SSI developed in 122 (3.5%); 71 (58.2%) were classified as superficial SSI and 51 (41.8%) as deep SSI. Surgical antimicrobial prophylaxis was employed in all cases. On average, infection occurred 21.5 days (range, 4 to 315) after CABG. Most cases were diagnosed on readmission (59%); 20 cases (16%) were identified by postdischarge surveillance. Microbiological data were positive in 109 (89.3%), with a single pathogen implicated in most (86.2%). Gram-positive cocci were most frequently recovered (81%); gram-negative bacilli (17%), gram-positive bacilli (1%), and yeast (1%) were less common.Staphylococcus aureuswas the most frequently isolated pathogen (49%). Bacteremia was noted in 22 instances (18%). It was significantly associated with deep SSI (P=. 002) and identified only inS. aureuscases.Conclusions:SSI complicated 3.5% of the procedures.S. aureuswas implicated in most of the cases and was significantly associated with deep SSI. It was the only pathogen associated with secondary bacteremia. In addition to standard guidelines, targeted methods againstS. aureusshould help reduce the overall rate of SSI.

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