A Multicenter Observational Analysis of Patient-, Clinician-, and Institution-level Variation in Inotrope Use for Cardiac Surgery

The dangers and advantages of inotropic medications used during cardiac surgery are controversial, and it is still unknown how clinical practices vary. The authors thus tried to quantify the contributions of the hospital, anesthesiologist, and patient to variance in inotrope usage. Half of the patients in a nationwide, multicenter cohort of heart 
operations at university and community hospitals received intraoperative inotrope infusions. Along with patient-level characteristics, variations in inotrope usage were explained by clinician- and institution-level variables. In order to determine if cardiac surgery outcomes may be improved and whether unnecessary variance can be decreased, additional prospective studies of patient-centered inotrope usage are recommended in light of the findings that reveal the amount of cardiac anesthesiology practice variation