Effect of Fast-Track Postoperative Recovery on Patients Outcome in Conventional Adult Cardiac Surgery

Background: Enhanced recovery after surgery ERAS is defined as multimodal perioperative measures designed to achieve safe and early recovery after major surgery. It involves multidisciplinary evidence-based measures. Aim of the work: To assess the impact of applying a fast-track recovery protocol on patients' outcomes in conventional adult cardiac surgery and compare it with conventional routine peri-operative management. Patients and Methods: This is a single-center retrospective observational and comparative study including 300 cases scheduled for elective cardiac surgery at the Cardiothoracic Surgery Department, Tanta University from January 2019 to January 2023. Cases were divided into 2 groups: Group A conventional management group; n=150 with routine perioperative management and Group B early recovery group; n=150 who received the fast-track protocol. Results: The study revealed highly significant differences between the 2 groups favoring the ERAS group, which proved superior to the conventional management group regarding total hospital stay 6.06 ± 0.48 days vs 7.99 ± 0.79 days; P < 0.001, intensive care unit stay 53.91 ± 3.55 hours vs 79.97 ± 7.85 hours; P < 0.001, time of mechanical ventilation 20.2 ± 1.49 hours vs 50.49 ± 3.58 hours; P < 0.001, intensive care unit readmission rate 4 cases vs 30 cases; P <0.001, reintubation rate 3 cases vs 23 cases; P < 0.0001, incidence of gastrointestinal complications 4 cases vs 16 cases; P = 0.005 and degree of patient satisfaction P < 0.001. Conclusion: Applying an ERAS protocol to cardiac surgery patients achieved better results regarding morbidity and mortality compared to conventional management.