title: Risk factors for coronary artery bypass graft chest surgical site infections in New York State, 2008.
abstract: BACKGROUND
  All hospitals in New York State (NYS) are required to report surgical site infections (SSIs) occurring after coronary artery bypass graft surgery. This report describes the risk adjustment method used by NYS for reporting hospital SSI rates, and additional methods used to explore remaining differences in infection rates.
  
  
  METHODS
  All patients undergoing coronary artery bypass graft surgery in NYS in 2008 were monitored for chest SSI following the National Healthcare Safety Network protocol. The NYS Cardiac Surgery Reporting System and a survey of hospital infection prevention practices provided additional risk information. Models were developed to standardize hospital-specific infection rates and to assess additional risk factors and practices.
  
  
  RESULTS
  The National Healthcare Safety Network risk score based on duration of surgery, American Society of Anesthesiologists score, and wound class were not highly predictive of chest SSIs. The addition of diabetes, obesity, end-stage renal disease, sex, chronic obstructive pulmonary disease, and Medicaid payer to the model improved the discrimination between procedures that resulted in SSI and those that did not by 25%. Hospital-reported infection prevention practices were not significantly related to SSI rates.
  
  
  CONCLUSIONS
  Additional risk factors collected using a secondary database improved the prediction of SSIs, however, there remained unexplained variation in rates between hospitals.
authors: Bureau of Healthcare-Associated Infections, New York State Department of Health, Albany, NY, USA. vbh03@health.state.ny.us
authors: Valerie B
authors: VB
authors: Haley
authors: Carole
authors: C
authors: Van Antwerpen
authors: Marie
authors: M
authors: Tsivitis
authors: Diana
authors: D
authors: Doughty
authors: Kathleen A
authors: KA
authors: Gase
authors: Peggy
authors: P
authors: Hazamy
authors: Boldtsetseg
authors: B
authors: Tserenpuntsag
authors: Michael
authors: M
authors: Racz
authors: M Recai
authors: MR
authors: Yucel
authors: Louise-Anne
authors: LA
authors: McNutt
authors: Rachel L
authors: RL
authors: Stricof
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*