Article description

Summary:

• This meta-analysis aimed to assess the impact of ERAS programs in cardiac surgery on hospital length of stay, mortality, atrial fibrillation, and quality of life;
• The meta-analysis included 18 studies with a study population sample size of 4,479 patients;
• The meta-analysis included one randomized controlled trial (RCT), with the remaining studies being retrospective or prospective cohort designs;
• The majority of studies compared a group receiving care by an ERAS protocol with a control group undergoing standard care;
• The implementation of ERAS was associated with a reduction in hospital length of stay of 1.24 days (95% CI: 1.67, 0.82, p < 0.001, I2 = 83%);
• No significant differences were observed between the groups in mortality (odds ratio: 0.65, 95% CI: 0.28, 1.48, p = 0.3, I2 = 0%), nor in the incidence of atrial fibrillation (odds ratio: 0.77, 95% CI: 0.57, 1.03, p = 0.08, I2 = 17%);
• A meta-analysis of quality of life was not feasible due to insufficient data.

Conclusions:

• The authors’ findings show that ERAS protocols in cardiac surgery are associated with a modest reduction in hospital length of stay, with no significant impact on postoperative mortality or incidence of atrial fibrillation.
• To support the implementation of ERAS programs in cardiac surgery, randomized studies are needed to demonstrate their efficacy, along with research that includes quality of life and other patient-centered recovery outcomes.