Enhanced Recovery After Cardiac Surgery: Gender Insights From an Ultra-Fast-Track Protocol.

Area of Science:

• Cardiac Surgery
• Enhanced Recovery After Surgery (ERAS)
• Minimally Invasive Surgery

Background:

• Female patients are underrepresented in cardiac surgery research.
• Women undergoing cardiac surgery may experience worse postoperative outcomes.
• Ultra-Fast-Track (UFT) Enhanced Recovery After Surgery (ERAS) is an intensified approach to postoperative care.

Purpose of the Study:

• To investigate gender-mediated differences in outcomes within a UFT-ERAS program.
• To assess UFT-ERAS achievement and postoperative complications in male and female cardiac surgery patients.
• To identify potential disparities in recovery pathways based on sex.

Main Methods:

• Retrospective cohort analysis of 800 consecutive patients undergoing UFT-ERAS for minimally invasive valve and aortic surgery.
• Patients were divided by gender.
• Primary outcome: UFT-ERAS achievement score (0-5 milestones); Secondary outcomes: MACE, reoperation, reintubation, ICU readmission, AKI, AF, delirium, transfusion.

Main Results:

• Women were older with higher baseline risk scores.
• Overall ERAS adherence and major postoperative complications were similar between sexes.
• Women had less frequent discharge within 7 days and more frequent need for postoperative transfusion.

Conclusions:

• Sex was not independently associated with overall UFT-ERAS achievement in this cohort.
• Women were less likely to achieve discharge within 7 days.
• Women more frequently required blood transfusions postoperatively.