Postoperative pneumonia in isolated coronary artery bypass grafting: A comprehensive study of epidemiology, etiology, and disease burden from China (2020–2023)

Abstract

Objective To investigate the epidemiological trends,etiological profiles and disease burden metrics related to postoperative pneumonia following isolated coronary artery bypass grafting (CABG). Methods A retrospective analysis was conducted on data from 518 patients who developed postoperative pneumonia following isolated CABG between January 1, 2020, and November 30, 2023. Results Postoperative pneumonia occurred at a rate of 11.34% among the cohort (518/4569),which fluctuated by year (P < 0.001). Patients aged 60–80 and over 80 years exhibited significantly higher incidence rates compared to those under 60 years (all P < 0.05) A total of 416 strains were identified, with Gram-negative bacteria accounting for 86.5%, primarily represented by Klebsiella pneumoniae (31.0%), while pseudomonas aeruginosa (21.4%) and stenotrophomonas maltophilia (5.3%) demonstrated an increasing trend in the period of 2022–2023 (both P < 0.05). The proportion of Staphylococcus aureus in the fourth quarter was significant lower than that in the first quarter (4.8% vs 14.4%, P < 0.05). The overall detection rate of multi-drug resistant organisms (MDRO) was 57.7%,with 53.9% for Gram-negative bacteria and 82.1% for Gram-positive bacteria.Late-onset postoperative pneumonia was significantly associated with a higher detection rate of MDRO (63.8% vs 50.3%, P < 0.01). Postoperative pneumonia prolonged median length of postoperative hospital[20.00 (13.00,31.25) days vs 15.50(10.25,19.75) days, P < 0.001] and ICU [9.00(5.00,14.00)days vs 4.00(3.00,11.75) days, P = 0.002] stay, thereby increasing hospitalization costs[￥255592.15 (193384.29, 336337.53) vs ￥180501.02 (154493.58, 220501.03),P < 0.001]. The incidence of severe pneumonia significantly increased in patients infected with MDRO (19.30% vs. 5.51%, P < 0.001) or co-infected (40.00% vs. 9.52%, P < 0.001), leading to marked differences in postoperative hospital stay and hospitalization costs (all P < 0.05). Conclusion The etiological patterns of postoperative pneumonia following isolated CABG showed temporal variations by year and quarter. MDRO infection and co-infections could significantly exacerbate the disease burden on patients.