Fast tracking in cardiac surgery: is it safe?

Autor: Jeffrey B. MacLeod, Kenneth D’Souza, Christie Aguiar, Craig D. Brown, Zlatko Pozeg, Christopher White, Rakesh C. Arora, Jean-François Légaré, Ansar Hassan
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Cardiothoracic Surgery, Vol 17, Iss 1, Pp 1-8 (2022)
Druh dokumentu: article
ISSN: 1749-8090
DOI: 10.1186/s13019-022-01815-9
Popis: Abstract Background While fast track clinical pathways have been demonstrated to reduce resource utilization in patients undergoing cardiac surgery, it remains unclear as to whether they adversely affect post-operative outcomes. The purpose of this study was to determine the impact of fast tracking on post-operative outcomes following cardiac surgery. Methods In a retrospective study, all patients undergoing first-time, on-pump, non-emergent coronary artery bypass grafting, valve, or coronary artery bypass grafting + valve at a single centre between 2010 and 2017 were included. Patients were considered to have been fast tracked if they were extubated and transferred from intensive care to a step-down unit on the same day as their procedure. The risk-adjusted effect of fast tracking on a 30-day composite of all-cause mortality, stroke, renal failure, infection, atrial fibrillation, and readmission to hospital was determined. Furthermore, propensity score matching was used to match fasting track patients in a 1-to-1 manner with their nearest “neighbor” in the control group and subsequently compared in terms of 30-day post-operative outcomes. Results 3252 patients formed the final study population (fast track: n = 245; control: n = 3007). Patients who were fast tracked experienced reduced time to initial extubation (4.3 vs. 5.6 h, p
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