Safe and effective protocol for discharge 3 days after cardiac surgery

Mejia, Omar Asdrúbal Vilca; Borgomoni, Gabrielle Barbosa; Lasta, Nilza; Okada, Mariana Yumi; Gomes, Mariana Silva Biason; Foz, Mary Lee Norris Nelsen; Bischoff, Helga Priscila Giugno; Saruhashi, Tatiana; Melro, Livia Maria Garcia; Sampaio, Márcio Campos; de Barros e Silva, Pedro Gabriel Melo; Garcia, José Carlos Teixeira; Furlan, Valter

The Enhanced Recovery After Surgery (ERAS) protocol affected traditional cardiac surgery processes and COVID-19 is expected to accelerate its scalability. The aim of this study was to assess the impact of an ERAS-based protocol on the length of hospital stay after cardiac surgery. From January 2019 to June 2020, 664 patients underwent consecutive cardiac surgery at a Latin American center. Here, 46 patients were prepared for a rapid recovery through a multidisciplinary institutional protocol based on the ERAS concept, the “TotalCor protocol”. After the propensity score matching, 46 patients from the entire population were adjusted for 12 variables. Patients operated on the TotalCor protocol had reduced intensive care unit time (P < 0.025), postoperative stay (P ≤ 0.001) and length of hospital stay (P ≤ 0.001). In addition, there were no significant differences in the occurrence of complications and death between the two groups. Of the 10-central metrics of TotalCor protocol, 6 had > 70% adherences. In conclusion, the TotalCor protocol was safe and effective for a 3-day discharge after cardiac surgery. Postoperative atrial fibrillation and renal failure were predictors of postoperative stay > 5 days.