Cost-Benefit of a Fast-Track Recovery Program in Cardiac Surgery

pp 505-510

Abstract

Background

The aim of this work was to demonstrate the advantages of a "rapid postoperative recovery"system -without conventional intensive care- by using a "cardiac surgical recovery area", to decrease cardiac surgery costs.

Material and method

140 patients (Group I) undergoing elective cardiac surgery whose postoperative recovery was done in a"cardiac surgical recovery area" within a program including restriction of homologous transfusion, early extubation and minimal invasive monitoring, were prospectively studied. In Group II (n = 160) recovery was done in a traditional intensive care unit.ResultsIn Group I, 95% of patients were extubated within an hour of the end of surgery versus 20% of Group II (p < 0.001). Group I showed 12.8% of major respiratory complications versus 27% of Group II (p <0.01). Group II needed more inotropics drugs andSwan-Ganz catheter (p < 0.05). 58% of Group I required postoperative homologous transfusion versus 87% of Group II (p < 0.001). Average postoperative studies were inferior in Group I (p < 0.001).

Conclusions

Use of a "cardiac surgical recovery area" and a rapid recovery program decreased time of intubation, respiratory morbidity, utilization of invasive monitor-ing and postoperative tests with the resultant alleviation of costs.