Hospital variability of postoperative sepsis and sepsis-related mortality after elective coronary artery bypass grafting surgery

Purpose: Hospital variability of postoperative sepsis and sepsis-related mortality after elective CABG surgery was not known in Australia. Material and methods: Population-based analysis of all elective patients who underwent CABG surgery in public and private hospitals between 2007 and 2014 using linked data from the state-wide Admitted Patient Data Collection and the NSW Registry of Births, Deaths, and Marriages. Results: We identified 18,928 (9464 pairs) matched patients who had elective CABG surgery in public hospitals (n = 9) and private hospitals (n = 13) during the study period. When compared to public hospital patients, private hospital patients had a significantly lower rate of post-CABG sepsis (13.3 vs 20.4 per 1000 admissions, P < 0.001; treatment effects: −7.1, 95%CI: −11.1 to −3.3), a lower in-hospital mortality rate (6.1 vs 9.9 per 1000 admissions, P = 0.006; treatment effects: −3.8, 95%CI: −6.5 to −1.1), and a lower rate of 30-day readmission (11.9% vs 13.9%, P < 0.001; treatment effects: −2.0%, 95%CI: −3.1% to −1.0%). In addition, for both public and private hospital groups, there were significant differences for all outcomes when comparing the worst and best performance quintile hospitals. Conclusions: Hospital variability of postoperative sepsis, in-hospital mortality and readmission after elective CABG existed between and within public and private hospitals.