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Epidemiology and perioperative factors contributing to postoperative pneumonia in patients undergoing isolated coronary artery bypass grafting: a retrospective Chinese study

Published online by Cambridge University Press:  24 April 2025

Yuxiao Zhan ,
Yang Yang ,
Jian Zhang ,
Rui Yang  and
Guojun Zhang Open the ORCID record for Guojun Zhang [Opens in a new window]
Yuxiao Zhan
Affiliation:
Department of Nosocomial Infection Control, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
Yang Yang
Affiliation:
Department of Nosocomial Infection Control, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
Jian Zhang
Affiliation:
Department of Cardiovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
Rui Yang
Affiliation:
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
Guojun Zhang*
Affiliation:
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
*
Corresponding author: Guojun Zhang; Email: [email protected]
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Abstract

Background:

Despite the existent studies investigating the risk factors for postoperative pneumonia (POP) following coronary artery bypass grafting (CABG), the comprehensive understanding of POP is constrained by the scarcity of epidemiological data.

Objective:

To investigate the epidemiology and contributing factors of POP in patients undergoing isolated CABG, and establish a prediction model.

Design:

A single center, retrospective case-control study.

Setting:

Seven cardiovascular surgery wards across three campuses of a large general hospital in Henan Province, Mid-China.

Participants:

Patients aged ≥ 18 years who underwent isolated CABG between January 1, 2020 and November 30, 2023.

Methods:

Univariate and multivariate analyses with restricted cubic splines (RCS) were performed to identify factors that independently contributed to POP and explore the potential nonlinear relationships. The prediction model was evaluated via receiver operating characteristic curve analysis.

Results:

POP occurred in 11.34% of patients (518/4569). A total of 416 pathogenic strains were isolated from 381 patients, predominantly Gram-negative bacteria (86.5%). Pathogen distribution varied annually and quarterly. Multivariate analyses indicated that age, diabetes mellitus, smoking, operative duration, red blood cell transfusion, and duration of mechanical ventilation were significantly associated with higher POP risk, whereas higher hemoglobin and total cholesterol levels indicated a reduced likelihood. RCS analysis revealed a nonlinear relationship between operative duration and POP. The prediction model demonstrated a high predictive value (C-statistic: 0.774, 95% CI: 0.735-0.813).

Conclusions:

This study identified eight independent factors that significantly influence the risk of POP following CABG, thereby clarifying the direction for optimizing perioperative prevention strategies for POP.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , First View , pp. 1 - 7
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

#

Yuxiao Zhan and Yang Yang contributed equally to this manuscript.

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