Heart Surgery's Deadly Risk: 60% Women are More Vulnerable

Up to six months following heart surgery, one in five older persons suffer an infection; women are much more likely to get one, according to research from Michigan Medicine. The studies looked at thousands of Medicare beneficiaries who had aortic valve replacement or coronary artery bypass grafting, commonly referred to as CABG or heart bypass. Postoperative infections, of which urinary tract, pneumonia, and sepsis were the three most frequent, were 60% more likely to occur in women. Additionally, total infection rates were greater among black patients (28%) than among white patients (19.2%).^[1]

A study from the U-M Health Department of Cardiac Surgery revealed ongoing differences in the results of patients having heart surgery that will need to be addressed by interdisciplinary teams.

Up to six months following surgery, 21.2% of Medicare recipients experienced an infection in one study that included hospitals throughout the state of Michigan. Nearly 17% of all infections were caused by pneumonia and UTIs, and infection rates ranged by over 40% between institutions.

Because certain hospitals are better suited to prevent infections than others and because certain patients suffer disproportionate obstacles due to social determinants of health, it is vital to track infections beyond the short time horizon. Researchers said the extended six-month follow-up time in the two current trials is probably the reason for the higher numbers.

Although research on attributable mortality has only included critically sick patients, hospital-acquired infections (HAIs) are a well-known cause of morbidity in hospitalized patients. According to the evidence currently available, HAIs are linked to a higher death rate, particularly in patients who have pneumonia, bloodstream infections (BSIs), or surgical indications for admission.^[2]

According to Charles Schwartz, M.D., chair of the Department of Surgery at Trinity Health Oakland and co-author of both of this research, the majority of national registries do not monitor these extra infections or carry out surveillance after 30 days following the treatment.

This could lead to a significant underestimation of the infection burden after heart surgery.

In Michigan, about half of all heart surgery procedures involve heart bypass and aortic valve replacement. Over 70% of all cardiac surgeries performed nationwide are CABG procedures.

According to a Michigan study, individuals who had surgery at hospitals with worse performance records and higher anticipated infection rates were more likely to be sent to long-term care or rehabilitation centers. Later-occurring infections found in this study may be influenced by other age-related medical disorders such as diabetes, high blood pressure, and cancer.

References:

1. Moss, Elliott, and Duke E. Cameron. "History of the Blalock–Taussig–Thomas Shunt: The Classic Approach to Pulmonary Blood Flow Augmentation." The Journal of Thoracic and Cardiovascular Surgery 161, no. 6 (2021): 2147-2153. Accessed March 6, 2025. https://www.jtcvs.org/article/S0022-5223(20)32486-7/pdf.

(Input from various sources)

(Rehash/Dr.Noureen/SSK)