PMID- 34849684
OWN - NLM
STAT- MEDLINE
DCOM- 20220602
LR  - 20220831
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 61
IP  - 6
DP  - 2022 May 27
TI  - The longitudinal impact of division-wide implementation of an enhanced recovery 
      after thoracic surgery programme.
PG  - 1223-1229
LID - 10.1093/ejcts/ezab492 [doi]
AB  - OBJECTIVES: Data regarding enhanced recovery after thoracic surgery (ERATS) are 
      sparse and inconsistent. This study aims to evaluate the effects of implementing 
      an enhanced ERATS programme on postoperative outcomes, patient experience and 
      quality of life (QOL). METHODS: We conducted a prospective, longitudinal study 
      evaluating 9 months before (pre-ERATS) and 9 months after (post-ERATS) a 3-month 
      implementation of an ERATS programme in a single academic tertiary care centre. 
      All patients undergoing major thoracic surgeries were included. The primary 
      outcomes included length of stay (LOS), adverse events (AEs), 6-min walk test 
      scores at 4 weeks, 30-day emergency room visits (without admission) and 30-day 
      readmissions. The process-of-care outcomes included time to 'out-of-bed', 
      independent ambulation, successful fluid intake, last chest tube removal and 
      removal of urinary catheter. Perioperative anaesthesia-related outcomes were 
      examined as well as patient experience and QOL scores. RESULTS: The pre-ERATS 
      group (n = 352 patients) and post-ERATS group (n = 352) demonstrated no 
      differences in demographics. Post-ERATS patients had improved LOS (4.7 vs 
      6.2 days, P < 0.02), 6-min walk test scores (402 vs 371 m, P < 0.05) and 30-day 
      emergency room visits (13.7% vs 21.6%, P = 0.03) with no differences in AEs and 
      30-day readmissions. Patients experienced shorter mean time to 'out-of-bed', 
      independent ambulation, successful fluid intake, last chest tube removal and 
      urinary catheter removal. There were no differences in postoperative analgesia 
      administration, patient satisfaction and QOL scores. CONCLUSIONS: ERATS 
      implementation was associated with improved LOS, expedited feeding, ambulation 
      and chest tube removal, without increasing AEs or readmissions, while maintaining 
      a high level of patient satisfaction and QOL.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the 
      European Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Thompson, Calvin
AU  - Thompson C
AUID- ORCID: 0000-0001-7220-0990
AD  - Dept. of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, ON, 
      Canada.
FAU - Mattice, Amanda M S
AU  - Mattice AMS
AD  - Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
FAU - Al Lawati, Yaseen
AU  - Al Lawati Y
AUID- ORCID: 0000-0002-3102-2021
AD  - Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
FAU - Seyednejad, Nazgol
AU  - Seyednejad N
AD  - Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
FAU - Lee, Alex
AU  - Lee A
AUID- ORCID: 0000-0003-3842-1225
AD  - Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
FAU - Maziak, Donna E
AU  - Maziak DE
AD  - Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
FAU - Gilbert, Sebastian
AU  - Gilbert S
AD  - Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
FAU - Sundaresan, Sudhir
AU  - Sundaresan S
AD  - Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
FAU - Villeneuve, James
AU  - Villeneuve J
AUID- ORCID: 0000-0001-6620-6413
AD  - Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
FAU - Shamji, Farid
AU  - Shamji F
AD  - Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
FAU - Brehaut, Jamie
AU  - Brehaut J
AD  - Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
AD  - School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, 
      Canada.
FAU - Ramsay, Tim
AU  - Ramsay T
AUID- ORCID: 0000-0001-8478-8170
AD  - Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
FAU - Seely, Andrew J E
AU  - Seely AJE
AUID- ORCID: 0000-0002-6459-8801
AD  - Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
AD  - Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
CIN - Eur J Cardiothorac Surg. 2022 May 27;61(6):1230-1231. PMID: 35025984
MH  - *Enhanced Recovery After Surgery
MH  - Humans
MH  - Length of Stay
MH  - Longitudinal Studies
MH  - Prospective Studies
MH  - Quality of Life
MH  - Retrospective Studies
MH  - *Thoracic Surgery
OTO - NOTNLM
OT  - Adverse events
OT  - Enhanced recovery
OT  - Implementation
OT  - Length of stay
OT  - Thoracic surgery
EDAT- 2021/12/02 06:00
MHDA- 2022/06/03 06:00
CRDT- 2021/12/01 07:09
PHST- 2021/05/20 00:00 [received]
PHST- 2021/10/13 00:00 [revised]
PHST- 2021/10/18 00:00 [accepted]
PHST- 2021/12/02 06:00 [pubmed]
PHST- 2022/06/03 06:00 [medline]
PHST- 2021/12/01 07:09 [entrez]
AID - 6438080 [pii]
AID - 10.1093/ejcts/ezab492 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2022 May 27;61(6):1223-1229. doi: 10.1093/ejcts/ezab492.