Temporal trends in the incidence of surgical site infections in patients undergoing coronary artery bypass graft surgery: A population-based cohort study, 1993 to 2008

Faisal A. Alasmari, Imad M. Tleyjeh, Muhammad Riaz, Kevin L. Greason, Elie F. Berbari, Abinash Virk, Larry M. Baddour

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

Objective: To determine the incidence of and temporal trends in surgical site infections (SSIs) in patients underoing coronary artery bypass graft (CABG) surgery. Methods: A population-based cohort study was conducted to describe the epidemiologic features of SSI in Olmsted County, Minnesota, between January 1, 1993, and December 31, 2008, using the Rochester Epidemiology Project. Period-specific incidence rates (in-hospital or within 30 days outside the hospital) were calculated. Logistic regression analysis was used to adjust for potential confounders that could affect temporal trends in SSI incidence rates. Results: During the 16-year study, of 1424 residents of Olmsted County who underwent CABG surgery, 1189 (83%) had isolated CABG and 235 (17%) had combined CABG and valve surgery. The overall SSI incidence rate was 7.0% (95% confidence interval [CI], 5.7%-8.4%). The incidence rate of superficial sternal SSI was 2.0% (95% CI, 1.2%- 2.7%) and of deep sternal SSI was 1.5% (95% CI, 0.9%-2.2%). The leg harvest site infection rate was 3.6% (95% CI, 2.6 %-4.5%). The incidence rate decreased over time with a statistically significant linear trend. The adjusted odds ratio (95% CI) of SSI showed a decreasing linear trend: 0.39 (0.19-0.81) vs 0.50 (0.27-0.93) vs 0.83 (0.48-1.42) vs reference for 2005-2008 vs 2001-2004 vs 1997-2000 vs 1993-1996. Conclusion: In this population-based surveillance study of patients undergoing CABG surgery, the incidence of SSI decreased markedly between 1993 and 2008 in patients in Olmsted County. The factors responsible for this decrease are the focus of ongoing investigations.

Original languageEnglish (US)
Pages (from-to)1054-1061
Number of pages8
JournalMayo Clinic Proceedings
Volume87
Issue number11
DOIs
StatePublished - 2012

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Surgical Wound Infection
Coronary Artery Bypass
Cohort Studies
Transplants
Incidence
Population
Confidence Intervals
Population Surveillance
Leg
Epidemiology
Logistic Models
Odds Ratio
Regression Analysis

ASJC Scopus subject areas

  • Medicine(all)

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Temporal trends in the incidence of surgical site infections in patients undergoing coronary artery bypass graft surgery : A population-based cohort study, 1993 to 2008. / Alasmari, Faisal A.; Tleyjeh, Imad M.; Riaz, Muhammad; Greason, Kevin L.; Berbari, Elie F.; Virk, Abinash; Baddour, Larry M.

In: Mayo Clinic Proceedings, Vol. 87, No. 11, 2012, p. 1054-1061.

Research output: Contribution to journalReview article

Alasmari, Faisal A. ; Tleyjeh, Imad M. ; Riaz, Muhammad ; Greason, Kevin L. ; Berbari, Elie F. ; Virk, Abinash ; Baddour, Larry M. / Temporal trends in the incidence of surgical site infections in patients undergoing coronary artery bypass graft surgery : A population-based cohort study, 1993 to 2008. In: Mayo Clinic Proceedings. 2012 ; Vol. 87, No. 11. pp. 1054-1061.
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title = "Temporal trends in the incidence of surgical site infections in patients undergoing coronary artery bypass graft surgery: A population-based cohort study, 1993 to 2008",
abstract = "Objective: To determine the incidence of and temporal trends in surgical site infections (SSIs) in patients underoing coronary artery bypass graft (CABG) surgery. Methods: A population-based cohort study was conducted to describe the epidemiologic features of SSI in Olmsted County, Minnesota, between January 1, 1993, and December 31, 2008, using the Rochester Epidemiology Project. Period-specific incidence rates (in-hospital or within 30 days outside the hospital) were calculated. Logistic regression analysis was used to adjust for potential confounders that could affect temporal trends in SSI incidence rates. Results: During the 16-year study, of 1424 residents of Olmsted County who underwent CABG surgery, 1189 (83{\%}) had isolated CABG and 235 (17{\%}) had combined CABG and valve surgery. The overall SSI incidence rate was 7.0{\%} (95{\%} confidence interval [CI], 5.7{\%}-8.4{\%}). The incidence rate of superficial sternal SSI was 2.0{\%} (95{\%} CI, 1.2{\%}- 2.7{\%}) and of deep sternal SSI was 1.5{\%} (95{\%} CI, 0.9{\%}-2.2{\%}). The leg harvest site infection rate was 3.6{\%} (95{\%} CI, 2.6 {\%}-4.5{\%}). The incidence rate decreased over time with a statistically significant linear trend. The adjusted odds ratio (95{\%} CI) of SSI showed a decreasing linear trend: 0.39 (0.19-0.81) vs 0.50 (0.27-0.93) vs 0.83 (0.48-1.42) vs reference for 2005-2008 vs 2001-2004 vs 1997-2000 vs 1993-1996. Conclusion: In this population-based surveillance study of patients undergoing CABG surgery, the incidence of SSI decreased markedly between 1993 and 2008 in patients in Olmsted County. The factors responsible for this decrease are the focus of ongoing investigations.",
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T1 - Temporal trends in the incidence of surgical site infections in patients undergoing coronary artery bypass graft surgery

T2 - A population-based cohort study, 1993 to 2008

AU - Alasmari, Faisal A.

AU - Tleyjeh, Imad M.

AU - Riaz, Muhammad

AU - Greason, Kevin L.

AU - Berbari, Elie F.

AU - Virk, Abinash

AU - Baddour, Larry M.

PY - 2012

Y1 - 2012

N2 - Objective: To determine the incidence of and temporal trends in surgical site infections (SSIs) in patients underoing coronary artery bypass graft (CABG) surgery. Methods: A population-based cohort study was conducted to describe the epidemiologic features of SSI in Olmsted County, Minnesota, between January 1, 1993, and December 31, 2008, using the Rochester Epidemiology Project. Period-specific incidence rates (in-hospital or within 30 days outside the hospital) were calculated. Logistic regression analysis was used to adjust for potential confounders that could affect temporal trends in SSI incidence rates. Results: During the 16-year study, of 1424 residents of Olmsted County who underwent CABG surgery, 1189 (83%) had isolated CABG and 235 (17%) had combined CABG and valve surgery. The overall SSI incidence rate was 7.0% (95% confidence interval [CI], 5.7%-8.4%). The incidence rate of superficial sternal SSI was 2.0% (95% CI, 1.2%- 2.7%) and of deep sternal SSI was 1.5% (95% CI, 0.9%-2.2%). The leg harvest site infection rate was 3.6% (95% CI, 2.6 %-4.5%). The incidence rate decreased over time with a statistically significant linear trend. The adjusted odds ratio (95% CI) of SSI showed a decreasing linear trend: 0.39 (0.19-0.81) vs 0.50 (0.27-0.93) vs 0.83 (0.48-1.42) vs reference for 2005-2008 vs 2001-2004 vs 1997-2000 vs 1993-1996. Conclusion: In this population-based surveillance study of patients undergoing CABG surgery, the incidence of SSI decreased markedly between 1993 and 2008 in patients in Olmsted County. The factors responsible for this decrease are the focus of ongoing investigations.

AB - Objective: To determine the incidence of and temporal trends in surgical site infections (SSIs) in patients underoing coronary artery bypass graft (CABG) surgery. Methods: A population-based cohort study was conducted to describe the epidemiologic features of SSI in Olmsted County, Minnesota, between January 1, 1993, and December 31, 2008, using the Rochester Epidemiology Project. Period-specific incidence rates (in-hospital or within 30 days outside the hospital) were calculated. Logistic regression analysis was used to adjust for potential confounders that could affect temporal trends in SSI incidence rates. Results: During the 16-year study, of 1424 residents of Olmsted County who underwent CABG surgery, 1189 (83%) had isolated CABG and 235 (17%) had combined CABG and valve surgery. The overall SSI incidence rate was 7.0% (95% confidence interval [CI], 5.7%-8.4%). The incidence rate of superficial sternal SSI was 2.0% (95% CI, 1.2%- 2.7%) and of deep sternal SSI was 1.5% (95% CI, 0.9%-2.2%). The leg harvest site infection rate was 3.6% (95% CI, 2.6 %-4.5%). The incidence rate decreased over time with a statistically significant linear trend. The adjusted odds ratio (95% CI) of SSI showed a decreasing linear trend: 0.39 (0.19-0.81) vs 0.50 (0.27-0.93) vs 0.83 (0.48-1.42) vs reference for 2005-2008 vs 2001-2004 vs 1997-2000 vs 1993-1996. Conclusion: In this population-based surveillance study of patients undergoing CABG surgery, the incidence of SSI decreased markedly between 1993 and 2008 in patients in Olmsted County. The factors responsible for this decrease are the focus of ongoing investigations.

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