Cardiothoracic & vascular anesthesia
Enhanced Recovery After Surgery Is Associated With Reduced Hospital Length of Stay after Urgent or Emergency Isolated Coronary Artery Bypass Surgery at an Urban, Tertiary Care Teaching Hospital: An Interrupted Time Series Analysis With Propensity Score Matching
Authors' conclusion
Enhanced recovery after surgery was associated with reduced LOS after urgent or emergency CABG without adverse effects on prolonged ventilation, reintubation, intensive care unit readmission, or 30-day outcomes.
Study context
- Population
- Patients undergoing urgent or emergency isolated CABG at a tertiary care teaching hospital565 vs 330 propensity-matched
- Participants
- 1,012 patients
- Exposure
- Post-ERAS vs pre-ERAS
- Post-ERASn = 666
- Pre-ERASn = 346reference
- Outcome
- Hospital LOS
Methodological detailsinterrupted time series analysis, propensity-score matched, single institution
- Interrupted time series analysis
- Propensity-score matched
- Single institution
Main finding
As reported in the abstract
LOS (propensity-matched)
P = 0.015
Observational data: associations, not effects.
Further findings
Extubation within 6 hours
P = 0.003
Intraoperative ketamine use
P < 0.001
Ventilation time
P = 0.003
| Outcome | Post-ERAS | Pre-ERAS | β2 coefficient (CI) | P value |
|---|---|---|---|---|
| Mean LOS, adjusted segmental regression (n = 1,012)Reduced mean LOS of ≈2 days · interrupted time series | −1.943 (−3.766 to −0.121) | P = 0.037 | ||
| MME use on POD 1 and 2 | 69.6 (SD 62.2) | 99.0 (SD 61.6) | P < 0.001 |
Mean length of stay (LOS), adjusted segmental regression (n = 1,012)
- Stable trends for mean LOS and no change in slope pre- and post-ERAS
Safety
Reintubation, ICU readmission, 30-day morbidity
- No differences between groups
Original publication
Enhanced Recovery After Surgery Is Associated With Reduced Hospital Length of Stay after Urgent or Emergency Isolated Coronary Artery Bypass Surgery at an Urban, Tertiary Care Teaching Hospital: An Interrupted Time Series Analysis With Propensity Score Matching. J Cardiothorac Vasc Anesth. Published 14 October 2022. doi:10.
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