Postoperative outcomes of cardiovascular surgery managed by nurse practitioners

The significant workload of cardiovascular surgeons in Japan has led to a growing interest in implementing nurse practitioners as a means to address this issue. This study seeks to evaluate the postoperative outcomes of cardiovascular surgeries in which nurse practitioners were involved at our institution.

This study utilized a retrospective observational study design. This study included patients who underwent scheduled cardiovascular surgeries at our hospital between April 1, 2019, and March 31, 2024. Patients were divided into two groups for postoperative care management: the DR group (physician only) and the NP group (co-management by physician and nurse practitioner). The primary end point was the 30-day mortality. We compared the two groups.

A total of 394 patients were classified into two groups: DR group (n = 101) and NP group (n = 293). There was no significant difference in the 30-day mortality between the two groups. The NP group had significantly shorter hospital stay (NP 20.6 ± 11.1 vs. DR 24.0 ± 11.8; p = 0.01; effect size = 0.299), postoperative length of stay (NP 14.5 ± 8.9 vs. DR 18.0 ± 10.4; p = 0.001; effect size = 0.376), ICU stay (NP 5.2 ± 3.5 vs. DR 6.3 ± 4.5; p = 0.014; effect size = 0.284), and time until 50-m walking (NP 3.8 ± 3.5 vs. DR 5.1 ± 5.1; p = 0.004; effect size = 0.342). There were no significant differences in the incidence of postoperative complications between the two groups.

Nurse practitioners have the potential to provide safe care equivalent to that of physicians, and it may contribute to reduced hospital stays and improved postoperative recovery in patients.