Associations of hospital characteristics with nosocomial pneumonia after cardiac surgery can impact on standardized infection rates

To identify hospital-level factors associated with post-cardiac surgical pneumonia for assessing their impact on standardized infection rates (SIRs), we studied 43 691 patients in a cardiac surgery registry (2001–2011) in 16 hospitals. In a logistic regression model for pneumonia following cardiac s...

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Main Authors: Sanagou, M., Leder, K., Cheng, A., Pilcher, D., Reid, Christopher, Wolfe, R.
Format: Journal Article
Published: 2015
Online Access:http://hdl.handle.net/20.500.11937/13064
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author Sanagou, M.
Leder, K.
Cheng, A.
Pilcher, D.
Reid, Christopher
Wolfe, R.
author_facet Sanagou, M.
Leder, K.
Cheng, A.
Pilcher, D.
Reid, Christopher
Wolfe, R.
author_sort Sanagou, M.
building Curtin Institutional Repository
collection Online Access
description To identify hospital-level factors associated with post-cardiac surgical pneumonia for assessing their impact on standardized infection rates (SIRs), we studied 43 691 patients in a cardiac surgery registry (2001–2011) in 16 hospitals. In a logistic regression model for pneumonia following cardiac surgery, associations with hospital characteristics were quantified with adjustment for patient characteristics while allowing for clustering of patients by hospital. Pneumonia rates varied from 0·7% to 12·4% across hospitals. Seventy percent of variability in the pneumonia rate was attributable to differences in hospitals in their long-term rates with the remainder attributable to within-hospital differences in rates over time. After adjusting for patient characteristics, the pneumonia rate was found to be higher in hospitals with more registered nurses (RNs)/100 intensive-care unit (ICU) admissions [adjusted odds ratio (aOR) 1·2, P = 0·006] and more RNs/available ICU beds (aOR 1·4, P < 0·001). Other hospital characteristics had no significant association with pneumonia. SIRs calculated on the basis of patient characteristics alone differed substantially from the same rates calculated on the basis of patient characteristics and the hospital characteristic of RNs/100 ICU admissions. Since SIRs using patient case-mix information are important for comparing rates between hospitals, the additional allowance for hospital characteristics can impact significantly on how hospitals compare.
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spelling curtin-20.500.11937-130642017-09-13T14:59:50Z Associations of hospital characteristics with nosocomial pneumonia after cardiac surgery can impact on standardized infection rates Sanagou, M. Leder, K. Cheng, A. Pilcher, D. Reid, Christopher Wolfe, R. To identify hospital-level factors associated with post-cardiac surgical pneumonia for assessing their impact on standardized infection rates (SIRs), we studied 43 691 patients in a cardiac surgery registry (2001–2011) in 16 hospitals. In a logistic regression model for pneumonia following cardiac surgery, associations with hospital characteristics were quantified with adjustment for patient characteristics while allowing for clustering of patients by hospital. Pneumonia rates varied from 0·7% to 12·4% across hospitals. Seventy percent of variability in the pneumonia rate was attributable to differences in hospitals in their long-term rates with the remainder attributable to within-hospital differences in rates over time. After adjusting for patient characteristics, the pneumonia rate was found to be higher in hospitals with more registered nurses (RNs)/100 intensive-care unit (ICU) admissions [adjusted odds ratio (aOR) 1·2, P = 0·006] and more RNs/available ICU beds (aOR 1·4, P < 0·001). Other hospital characteristics had no significant association with pneumonia. SIRs calculated on the basis of patient characteristics alone differed substantially from the same rates calculated on the basis of patient characteristics and the hospital characteristic of RNs/100 ICU admissions. Since SIRs using patient case-mix information are important for comparing rates between hospitals, the additional allowance for hospital characteristics can impact significantly on how hospitals compare. 2015 Journal Article http://hdl.handle.net/20.500.11937/13064 10.1017/S0950268815002307 restricted
spellingShingle Sanagou, M.
Leder, K.
Cheng, A.
Pilcher, D.
Reid, Christopher
Wolfe, R.
Associations of hospital characteristics with nosocomial pneumonia after cardiac surgery can impact on standardized infection rates
title Associations of hospital characteristics with nosocomial pneumonia after cardiac surgery can impact on standardized infection rates
title_full Associations of hospital characteristics with nosocomial pneumonia after cardiac surgery can impact on standardized infection rates
title_fullStr Associations of hospital characteristics with nosocomial pneumonia after cardiac surgery can impact on standardized infection rates
title_full_unstemmed Associations of hospital characteristics with nosocomial pneumonia after cardiac surgery can impact on standardized infection rates
title_short Associations of hospital characteristics with nosocomial pneumonia after cardiac surgery can impact on standardized infection rates
title_sort associations of hospital characteristics with nosocomial pneumonia after cardiac surgery can impact on standardized infection rates
url http://hdl.handle.net/20.500.11937/13064