Structured preoperative ERAS nurse consultations were feasible and improved patient education, stress management, and targeted interventions in 92.9% of elective cardiac surgery patients.
Does a structured preoperative ERAS nurse consultation improve perioperative optimization and risk factor management in elective cardiac surgery patients?
Integrating a structured preoperative nurse consultation into routine elective cardiac surgery care is feasible and facilitates targeted risk factor management and patient preparation.
Absolute Event Rate: 0% vs 0%
Abstract Background Enhanced Recovery After Surgery (ERAS) protocols aim to improve perioperative care and patient outcomes. In elective cardiac surgery, preoperative risk assessment and targeted interventions help reduce complications and enhance recovery. To reinforce this process, we introduced a structured preoperative ERAS nurse consultation in close collaboration with a clinical cardiologist specializing in perioperative care. This partnership ensures a patient-centered approach, addressing modifiable risk factors and improving adherence to evidence-based protocols. Purpose This study evaluates the impact of a structured preoperative ERAS nurse consultation on perioperative optimization in patients undergoing elective coronary, valvular, and aortic surgery. Key areas of focus included education, stress management, frailty, anemia, nutrition, and addiction management (Picture 1). Methods A retrospective comparative analysis was conducted within the ongoing local cardiac ERAS registry. Since the launch of the ERAS cardiac surgery program in 2023, 353 elective cardiac surgery patients were included (median age: 64 years 55;72, 24.9% female). Surgical distribution included CABG (29.5%), isolated valve surgery (40.8%), combined valve and aortic surgery (13.0%), combined valve and CABG (7.65%), isolated aortic surgery (4.25%), and other procedures (4.82%). The median cardiopulmonary bypass duration was 72 minutes 56.0;91.0, and 9.13% of patients underwent redo surgery. Preoperative comorbidities included diabetes (20.7%) and active smoking (23.8%). The study was approved by the local ethics committee, and patients who refused general consent for data reuse were excluded. Results A total of 328 patients (92.9%) attended a structured preoperative nurse consultation. Education on perioperative pathways, stress management, and addiction screening, including targeted smoking and alcohol cessation counseling, was conducted for all screened patients. Nutritional assessment was performed in 323 patients (98.4%), with 19 patients (5.8%) requiring preoperative nutritional supplementation. Frailty screening led to 23 patients (6.52%) being referred for preoperative physiotherapy. Among 346 patients (98%) screened for ferropenic anemia, 25 (7%) received intravenous iron therapy before admission. Throughout this process, the ERAS nurse worked closely with a perioperative cardiologist to ensure a comprehensive risk assessment and management strategy. Conclusion Our experience confirms the feasibility of integrating a structured nurse consultation into routine cardiac surgery care. This approach enhances patient education, psychological preparation, and risk factor management, supporting improved perioperative optimization.
Verdugo-Marchese et al. (Sat,) reported a other. Structured preoperative ERAS nurse consultations were feasible and improved patient education, stress management, and targeted interventions in 92.9% of elective cardiac surgery patients.