Independent Risk Factors for Fast-Track Failure Using a Predefined Fast-Track Protocol in Preselected Cardiac Surgery Patients

Journal of Cardiothoracic and Vascular Anesthesia
Zakhary WaseemJoerg Ender

Abstract

The purpose of this study was to identify the independent risk factors for fast-track failure (FTF) in cardiac surgery patients. A retrospective analysis. A university-affiliated heart center. In a 2-year period, 1,704 consecutive preselected patients undergoing elective cardiac surgery were treated according to the local fast-track protocol in the postanesthetic care unit (PACU), bypassing the intensive care unit (ICU). Independent risk factors for FTF in the univariate regression analysis were tested in a multivariate regression analysis. FTF was defined as any transfer of the preselected patient to the ICU. FTF was primary when the patient was transferred directly from the postanesthetic care unit to the ICU and secondary when the patient was transferred from the intermediate care unit or ward to the ICU. FTF rate was 11.6% for primary and 5.6% for secondary FTF. In the multivariate regression analysis, age>70 years, female sex, prolonged surgery, and prolonged cross-clamp time could be defined as independent risk factors for FTF. In a preselected patient population, fast-track treatment could be done with a low FTF rate. Independent risk factors for FTF are age, female sex, prolonged surgery, and prolonged cross-clamp time.

References

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Citations

Aug 8, 2020·Journal of Clinical Nursing·Hilaine Cristina BatistiniRegimar Carla Machado
May 4, 2020·International Journal of Colorectal Disease·Si-Da SunQing-Liang He
Sep 14, 2017·International Anesthesiology Clinics·Longqiu YangHenry Liu
Oct 2, 2019·Journal of Cardiothoracic and Vascular Anesthesia·Alexander J GregoryJerrold H Levy
Mar 11, 2021·Seminars in Thoracic and Cardiovascular Surgery·Evan P RotarNicholas R Teman
Sep 24, 2020·Journal of Cardiothoracic and Vascular Anesthesia·L LiW Zhang
May 4, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Alexander J Gregory
Jul 31, 2021·The Annals of Thoracic Surgery·Robert E FreundlichDaniel W Byrne

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