Optimizing Prevention of Healthcare-Acquired Infections After Cardiac Surgery

NCT02068716 | Completed

• 2 other identifiers: HAI_Umich2004-0428
• Study Type: observational
• Target: 911,754
• Locations: 1 country
• Sites: 1

Brief Summary

Our Aim is to identify patient risk factors and clinical practices associated with healthcare-acquired infections (HAIs) after cardiac surgery. We will use prospectively collected data housed within the MSTCVS-QC (Michigan Society of Thoracic \& Cardiovascular Surgeons Quality Collaborative) to reveal risk factors that elevate a patient's risk of developing HAIs. The results of this analysis will form the foundation for the development of standardized regional practices to reduce HAIs. We will explore the effect of traditional patient-level measures (age, sex, comorbid conditions), process measures (timing and selection of antibiotics, continuous insulin infusion, transfusions), and surgical practices (use of bilateral internal mammary artery usage among diabetics, vein harvesting approach).

Conditions

Healthcare Associated Infectious Disease; Sternal Superficial Wound Infection; Sepsis; Pneumonia; Deep Sternal Infection

Keywords

Healthcare acquired infections; Cardiovascular Surgery; Mediastinitis; Thoracotomy; Conduit harvest or cannulation site

Outcome Measures

Primary Outcomes (1)

• Percent of patients having a healthcare-acquired infection (HAIs) post cardiac surgery.

  Overall HAIs include pneumonia, sepsis/septicemia, and surgical site infections, including deep sternal wound, thoracotomy, and harvest/cannulation site infections.

  In-hospital or within the first 30 days (for surgical infections) after surgery

Study Arms (1)

Adults with HAIs

Adult cardiac surgery patients who develop infections in hospitals within 30 days post surgery. We will exclude patients presenting with endocarditis.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients undergoing adult cardiac surgery

You may qualify if:

• Female and male adult patients 18 and over undergoing cardiac surgery within the state of Michigan from January 1, 2011 through June 30, 2013.

You may not qualify if:

• Pregnant women,
• children,
• endocarditis

Sponsors & Collaborators

• Dr. Donald Likosky: lead
• Agency for Healthcare Research and Quality (AHRQ): collaborator

Study Sites (1)

Mstcvs-Qc

Ann Arbor, Michigan, 48105, United States

Location

Related Publications (5)

• Shih T, Zhang M, Kommareddi M, Boeve TJ, Harrington SD, Holmes RJ, Roth G, Theurer PF, Prager RL, Likosky DS; Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative. Center-level variation in infection rates after coronary artery bypass grafting. Circ Cardiovasc Qual Outcomes. 2014 Jul;7(4):567-73. doi: 10.1161/CIRCOUTCOMES.113.000770. Epub 2014 Jul 1.

  PMID: 24987052 RESULT

• Likosky DS, Wallace AS, Prager RL, Jacobs JP, Zhang M, Harrington SD, Saha-Chaudhuri P, Theurer PF, Fishstrom A, Dokholyan RS, Shahian DM, Rankin JS; Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative. Sources of Variation in Hospital-Level Infection Rates After Coronary Artery Bypass Grafting: An Analysis of The Society of Thoracic Surgeons Adult Heart Surgery Database. Ann Thorac Surg. 2015 Nov;100(5):1570-5; discussion 1575-6. doi: 10.1016/j.athoracsur.2015.05.015. Epub 2015 Aug 28.

  PMID: 26321440 RESULT

• Strobel RJ, Liang Q, Zhang M, Wu X, Rogers MA, Theurer PF, Fishstrom AB, Harrington SD, DeLucia A 3rd, Paone G, Patel HJ, Prager RL, Likosky DS; Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative. A Preoperative Risk Model for Postoperative Pneumonia After Coronary Artery Bypass Grafting. Ann Thorac Surg. 2016 Oct;102(4):1213-9. doi: 10.1016/j.athoracsur.2016.03.074. Epub 2016 Jun 1.

  PMID: 27261082 RESULT

• Brescia AA, Rankin JS, Cyr DD, Jacobs JP, Prager RL, Zhang M, Matsouaka RA, Harrington SD, Dokholyan RS, Bolling SF, Fishstrom A, Pasquali SK, Shahian DM, Likosky DS; Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative. Determinants of Variation in Pneumonia Rates After Coronary Artery Bypass Grafting. Ann Thorac Surg. 2018 Feb;105(2):513-520. doi: 10.1016/j.athoracsur.2017.08.012. Epub 2017 Nov 23.

  PMID: 29174785 RESULT

• Likosky DS, Harrington SD, Cabrera L, DeLucia A 3rd, Chenoweth CE, Krein SL, Thibault D, Zhang M, Matsouaka RA, Strobel RJ, Prager RL. Collaborative Quality Improvement Reduces Postoperative Pneumonia After Isolated Coronary Artery Bypass Grafting Surgery. Circ Cardiovasc Qual Outcomes. 2018 Nov;11(11):e004756. doi: 10.1161/CIRCOUTCOMES.118.004756.

  PMID: 30571334 DERIVED

MeSH Terms

Conditions

Cross Infection; Sepsis; Pneumonia; Mediastinitis

Condition Hierarchy (Ancestors)

Infections; Iatrogenic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Systemic Inflammatory Response Syndrome; Inflammation; Respiratory Tract Infections; Lung Diseases; Respiratory Tract Diseases; Mediastinal Diseases; Thoracic Diseases

Study Officials

• Donald S Likosky, Ph.D.

  University of Michigan

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: February 19, 2014
• First Posted: February 21, 2014
• Study Start: March 1, 2014
• Primary Completion: September 29, 2018
• Study Completion: September 29, 2018
• Last Updated: October 23, 2018

Record last verified: 2018-10

Locations

US (1)