Assessing data sources for sustainable and continuous surveillance: surgical site infections following coronary artery bypass grafts in England

Background: Multiple national and local data sources collected by healthcare systems across Europe contain information regarding coronary artery bypass grafts (CABG). Currently surveillance for surgical site infections (SSIs) in this patient group is voluntary in the UK.

Aim: To investigate and compare the currently available data sources in England for SSI surveillance in CABG patients.

Methods: Data were extracted from the Society for Cardiothoracic Surgery in Great Britain and Ireland (SCTS) Adult Cardiac Surgery Registry, the Health Protection Agency SSI surveillance, and the Patient Administration System (PAS) from a single large National Health Service Trust. These data were deterministically linked using patient identifiers, anonymized, and then underwent descriptive analysis.

Findings: From 1 January 2011 to 30 June 2011, 306 patients were recorded in at least one dataset as having undergone CABG. Of these, 76% were recorded by all three data sources being investigated. Of the discordant patients, 5% were recorded by both the local cardiac registry and PAS, and 18% by both the HPA surveillance and PAS. A total of 28 surgical site infections were recorded, of which 21% were identified by all the data sources.

Conclusion: Currently, the databases which collect and store data relating to CABG patients suffer from duplications and discrepancies. Integration of the discordant systems is recommended to create a streamlined, sustainable electronic surveillance system.