Safe and effective protocol for discharge 3 days after cardiac surgery

Area of Science:

• Cardiology
• Surgical Innovation
• Healthcare Management

Background:

• Enhanced Recovery After Surgery (ERAS) protocols are transforming perioperative care.
• The COVID-19 pandemic is accelerating the adoption and scalability of ERAS protocols.
• Traditional cardiac surgery pathways are being re-evaluated for efficiency.

Purpose of the Study:

• To evaluate the impact of an ERAS-based protocol, "TotalCor protocol", on hospital stay duration following cardiac surgery.
• To assess the safety and efficacy of the TotalCor protocol in a Latin American cardiac surgery center.

Main Methods:

• A prospective study involving 664 cardiac surgery patients from January 2019 to June 2020.
• Implementation of the multidisciplinary TotalCor protocol for rapid recovery in 46 patients.
• Propensity score matching was used to adjust for 12 variables, comparing TotalCor patients with a control group.

Main Results:

• Patients managed with the TotalCor protocol demonstrated significantly reduced intensive care unit (ICU) time (P < 0.025).
• TotalCor protocol led to shorter postoperative hospital stays (P ≤ 0.001) and overall length of stay (P ≤ 0.001).
• No significant differences in complication rates or mortality were observed between the groups.

Conclusions:

• The TotalCor protocol is a safe and effective ERAS-based strategy for achieving 3-day hospital discharge after cardiac surgery.
• High adherence (over 70%) was observed for 6 out of 10 key TotalCor protocol metrics.
• Postoperative atrial fibrillation and renal failure were identified as predictors for extended postoperative stays exceeding 5 days.