Abstract OBJECTIVES Ultra-Fast-Track (UFT) Enhanced Recovery After Surgery (ERAS)—defined by on-table extubation, minimally invasive surgical technique and deescalated ICU care–represents an intensified ERAS approach. Female patients remain underrepresented in cardiac surgery research and experience worse postoperative outcomes. Therefore, we investigated possible gender-mediated differences in the outcomes of our UFT-ERAS program. METHODS 800 consecutive patients underwent UFT-ERAS for minimally invasive valve and aortic surgery at our institution 01/2021—09/2024. Patients were divided by gender and retrospective cohort analysis was performed. The primary outcome was UFT-ERAS achievement, defined by a 0–5 score of postoperative milestones (on-table extubation, postoperative intermediate care, early physiotherapy, transfer to general ward ≤24 h and hospital discharge ≤7 days). Secondary end-points were Major Adverse Cardiovascular Events (MACE), reoperation for bleeding, reintubation, ICU readmission, acute kidney injury, atrial fibrillation, delirium and transfusion. RESULTS Women were older and had higher baseline risk scores. Overall ERAS adherence and major postoperative complications were comparable between sexes. Only discharge ≤7 days was less frequent and postoperative transfusion need more frequent in women. In multivariable ordinal logistic regression adjusting for STS-PROM, age, and procedure type, sex was not independently associated with ERAS achievement (OR 0.88, 95% CI 0.66–1.18). CONCLUSIONS In this predominantly low-risk patient cohort within a UFT-ERAS pathway, sex was not independently associated with overall ERAS achievement. However, women more frequently required transfusion and were less likely to be discharged within 7 days.
Veith et al. (2026) studied this question.