Heart surgery can save lives and help people live longer and healthier lives. Every year, thousands of older adults undergo major heart operations to improve blood flow to the heart or replace damaged heart valves.
Many patients and families focus mainly on surviving the surgery itself and recovering during the first few weeks afterward. However, new research from Michigan Medicine shows that the recovery process may continue to carry serious health risks for many months after patients leave the hospital.
The new findings were published in The Journal of Thoracic and Cardiovascular Surgery. Researchers discovered that one in five older adults developed an infection within six months after heart surgery. The studies also found important differences in infection risk between different groups of patients and between hospitals.
The research focused on two of the most common heart surgeries performed in the United States. One was coronary artery bypass grafting, often called CABG or heart bypass surgery.
This operation helps improve blood flow to the heart when arteries become blocked. The second procedure was aortic valve replacement, which replaces a damaged heart valve that no longer works properly.
Together, these surgeries make up a large share of all heart operations performed in Michigan and across the country. CABG alone accounts for more than 70% of heart surgeries nationwide. Because so many older adults undergo these procedures, understanding the long-term risks after surgery is very important.
The Michigan Medicine team studied Medicare patients from hospitals across Michigan. They followed patients for six months after surgery instead of only looking at the first few weeks. This longer follow-up period allowed the researchers to discover many infections that previous studies may have missed.
The results were concerning. About 21.2% of older adults developed at least one infection within six months after surgery. The most common infections were urinary tract infections, often called UTIs, pneumonia, and sepsis.
Pneumonia is a lung infection that can make breathing difficult, while sepsis is a dangerous condition in which the body reacts severely to infection and can become life-threatening.
The studies also revealed major differences between patient groups. Women faced a much higher risk of infection compared with men. In fact, women had about 60% higher odds of developing an infection after surgery.
Researchers are still trying to understand all the reasons behind this difference, but the findings suggest that women may need closer monitoring during recovery.
Black patients were also found to have significantly higher infection rates than white patients. About 28% of Black patients developed infections compared with 19.2% of white patients. These numbers raised important concerns about healthcare inequality and differences in access to support, treatment, and recovery resources.
Another major finding was that infection rates varied greatly from one hospital to another. Some hospitals had much higher infection rates than others, with differences approaching 40%.
This suggests that hospital quality, infection prevention practices, discharge planning, and patient support systems may strongly affect recovery outcomes.
The researchers explained that earlier studies likely underestimated the true number of infections after heart surgery. Many national databases and past studies only tracked patients for about 30 days after surgery. However, some infections do not appear until much later.
By extending the follow-up period to six months, the Michigan Medicine researchers uncovered many additional infections that developed later during recovery. These included urinary tract infections and gastrointestinal infections that often occur after patients have already left the hospital or rehabilitation center.
Dr. Donald Likosky, senior author of the studies, said that older adults remain vulnerable long after surgery is completed. Many heart surgery patients also live with other health conditions such as diabetes, high blood pressure, kidney disease, or cancer. These conditions may weaken the body and increase the risk of infections during recovery.
Co-author Dr. Francis Pagani explained that patients treated at lower-performing hospitals were more likely to be sent to rehabilitation centers or extended care facilities after surgery. This finding suggests that the quality of hospital care can continue to affect patients long after they are discharged.
The studies also showed that solving these problems will require cooperation between hospitals, doctors, communities, and policymakers. First author Dr. J’undra Pegues emphasized that reducing infection risks and health disparities cannot be solved by one group alone.
The researchers pointed to earlier success stories that show improvement is possible. Between 2012 and 2017, a statewide quality improvement program in Michigan successfully lowered pneumonia rates among heart surgery patients compared with national averages.
Programs like this encourage hospitals to share knowledge and work together to improve patient care.
The research team believes future efforts should not only focus on medical treatment inside hospitals but also on the patient’s life after discharge. Recovery can be affected by many factors outside the hospital, including access to follow-up care, family support, transportation, nutrition, safe housing, and rehabilitation services.
The findings highlight that heart surgery recovery is often much longer and more complex than many people realize.
Even after patients return home, they may still face serious risks for months afterward. Doctors, caregivers, and families should pay close attention to signs of infection such as fever, breathing problems, pain, confusion, or unusual weakness.
The researchers hope their work will encourage hospitals and healthcare systems to improve long-term follow-up care for heart surgery patients. By reducing infections and improving support after discharge, they believe recovery can become safer and more equal for all patients.
In summary, the studies show that infections after heart surgery are more common than previously believed, especially among women and Black patients.
The research also shows that hospital quality and community support can strongly shape recovery outcomes. While progress has already been made in reducing some risks, the findings make clear that more work is needed to protect older adults during the months after heart surgery.
If you care about heart health, please read studies about top 10 foods for a healthy heart, and how to eat right for heart rhythm disorders.
For more health information, please see recent studies about how to eat your way to cleaner arteries, and salt and heart health: does less really mean more?
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