Journal Article

Mortality Associated with Bloodstream Infection after Coronary Artery Bypass Surgery

Margaret A. Olsen, Melissa Krauss, Denis Agniel, Mario Schootman, Clare N. Gentry, Yan Yan, Ralph J. Damiano and Victoria J. Fraser

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 46, issue 10, pages 1537-1546
Published in print May 2008 | ISSN: 1058-4838
Published online May 2008 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/587672
Mortality Associated with Bloodstream Infection after Coronary Artery Bypass Surgery

More Like This

Show all results sharing these subjects:

  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

GO

Show Summary Details

Preview

Background. Mortality attributable to bloodstream infection (BSI) is still controversial. We studied the impact of BSI on mortality after coronary artery bypass surgery, including the specific impact of different etiologic organisms.

Methods. Our cohort consisted of 4515 patients who underwent coronary artery bypass procedures at a university hospital from 1996 through 2004. We used Society of Thoracic Surgery data supplemented with laboratory and infection control data. Mortality dates were identified using Society of Thoracic Surgery data and the Social Security Death Index. BSI within 90 days after surgery was defined by a positive blood culture result. Cox proportional hazards and propensity score models were used to analyze the association between BSI and mortality.

Results. Patients with BSI had a 4.2-fold increased risk of death (95% confidence interval [CI], 3.0–5.9) 2–90 days after coronary artery bypass surgery, compared with uninfected patients. The risk of death was higher among patients with BSI due to gram-negative bacteria (hazard ratio [HR], 6.8; 95% CI, 3.9–12.0) and BSI due to Staphylococcus aureus (HR, 7.2; 95% CI, 3.3–15.7) and lowest among patients with BSI caused by gram-positive bacteria other than S. aureus (HR, 2.2; 95% CI, 1.1–4.6). The risk of death was highest among patients who developed BSI but had the lowest likelihood of infection (HR, 10.0; 95% CI, 3.5–28.8) and was lowest among patients who developed BSI but had the highest likelihood of infection (HR, 2.3; 95% CI, 1.2–4.6).

Conclusions. BSIs due to gram-negative bacteria and BSIs due to S. aureus contributed significantly to mortality. Mortality attributable to BSI was highest among patients predicted to be least likely to develop infection and was lowest among severely ill patients who were most likely to develop infection. BSI appears to be an important contributor to death after coronary artery bypass surgery, particularly among the healthiest patients.

Journal Article.  4440 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.