Original articleCongenital heart surgeryHospital Variation in Postoperative Infection and Outcome After Congenital Heart Surgery
Section snippets
Data Source
De-identified data from the STS-CHS and PHIS databases were linked at the individual patient level using the method of “indirect identifiers” as previously described and verified 7, 8, 9. The STS-CHS Database is the largest existing pediatric heart surgery registry, and collects data on all children undergoing heart surgery at greater than 100 participating North American centers. The PHIS Database is a large administrative database that collects information from the hospital bill from 41 US
Study Population
The study cohort included 32,856 patients from 28 centers. Patient characteristics overall and in those with and without infection are displayed in Table 1. The unadjusted rate of postoperative infection in the overall study population was 3.7%, and was highest in the following subgroups of patients: any noncardiac or genetic abnormality (5.3%), STAT categories 4-5 (7.5%), neonates (8.4%), and those with delayed sternal closure (11.5%). The types of infection are displayed in Table 2. Sepsis
Comment
In this multi-institutional analysis, we found that postoperative infection rates after congenital heart surgery varied widely across hospitals. Hospitals with higher infection rates had significantly longer LOS and increased costs. However, the magnitude of these differences was relatively small, with infection rates alone explaining only 15% of the total variation in costs and 6% of the total variation in LOS across hospitals.
This study supports the results of previous analyses which have
References (22)
- et al.
Variation in outcomes for benchmark operations: an analysis of the STS Congenital Heart Surgery Database
Ann Thorac Surg
(2011) - et al.
Major infection after pediatric cardiac surgery: a risk estimation model
Ann Thorac Surg
(2010) - et al.
Linking clinical registry data with administrative data using indirect identifiers: implementation and validation in the congenital heart surgery population
Am Heart J
(2010) - et al.
Comparative analysis of antifibrinolytic medications in pediatric heart surgery
J Thorac Cardiovasc Surg
(2012) - et al.
An empirically based tool for analyzing mortality associated with congenital heart surgery
J Thorac Cardiovasc Surg
(2009) - et al.
Bloodstream infections after median sternotomy at a children’s hospital
J Thorac Cardiovasc Surg
(2007) - et al.
Nosocomial infections after cardiac surgery in infants and children: incidence and risk factors
J Hosp Infect
(2003) - et al.
Variation in outcomes for risk-stratified pediatric cardiac surgical operations: an analysis of the STS Congenital Heart Surgery Database
Ann Thorac Surg
(2012) - et al.
Center variation in hospital costs for patients undergoing congenital heart surgery
Circ Cardiovasc Qual Outcomes
(2011) - CDC recommendations to prevent healthcare-associated infections. Available at:...
Cited by (45)
PICS/AEPC/APPCS/CSANZ/SCAI/SOLACI: Expert Consensus Statement on Cardiac Catheterization for Pediatric Patients and Adults With Congenital Heart Disease
2024, JACC: Cardiovascular InterventionsPICS/AEPC/APPCS/CSANZ/SCAI/SOLACI: Expert Consensus Statement on Cardiac Catheterization for Pediatric Patients and Adults With Congenital Heart Disease
2024, Journal of the Society for Cardiovascular Angiography and InterventionsVariation in Case-Mix Across Hospitals: Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database
2023, Annals of Thoracic SurgeryData and databases for pediatric and adult congenital cardiac care
2023, Intelligence-Based Cardiology and Cardiac Surgery: Artificial Intelligence and Human Cognition in Cardiovascular MedicineThe Value of Longitudinal Follow-Up and Linked Registries
2021, Journal of the American College of Cardiology
Dr. Pasquali's current affiliation is Department of Pediatrics, University of Michigan C. S. Mott Children's Hospital, Ann Arbor, MI.
- ∗
Co-senior authors.