Effect of Enhanced Recovery After Surgery (ERAS) Implementation on Postoperative Atrial Fibrillation in Cardiac Surgery
<b>Background/Objectives</b>: Postoperative atrial fibrillation (POAF) is the most frequent arrhythmic complication following cardiac surgery and is associated with increased morbidity and prolonged recovery. This study aimed to evaluate the impact of an enhanced recovery after surgery (...
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2025-05-01
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| author | Romain Niessen Valentina Rancati Mario Verdugo-Marchese Ziyad Gunga Anna Nowacka Valentine Melly Christophe Abellan Karima Alouazen Tamila Abdurashidova Caroline Botteau Matthias Kirsch Zied Ltaief |
| author_facet | Romain Niessen Valentina Rancati Mario Verdugo-Marchese Ziyad Gunga Anna Nowacka Valentine Melly Christophe Abellan Karima Alouazen Tamila Abdurashidova Caroline Botteau Matthias Kirsch Zied Ltaief |
| author_sort | Romain Niessen |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: Postoperative atrial fibrillation (POAF) is the most frequent arrhythmic complication following cardiac surgery and is associated with increased morbidity and prolonged recovery. This study aimed to evaluate the impact of an enhanced recovery after surgery (ERAS) program on the incidence of POAF and broader perioperative outcomes. <b>Methods</b>: In this monocentric, observational cohort study, we compared a retrospective pre-ERAS cohort (<i>n</i> = 162) with a prospective ERAS cohort (<i>n</i> = 321). The primary outcome was the incidence of POAF, assessed using two definitions: (1) the American Association for Thoracic Surgery (AATS) 2014 clinical definition, identifying POAF as atrial fibrillation requiring treatment; and (2) the European Society of Cardiology (ESC) 2024 definition, describing new-onset atrial fibrillation occurring immediately after surgery. Secondary outcomes included compliance with POAF prophylaxis measures, length of hospital stay, and the occurrence of postoperative complications. Statistical analyses included propensity score matching and multivariate logistic regression to identify independent predictors of POAF. <b>Results</b>: ERAS implementation was associated with a significant reduction in POAF incidence across both definitions. According to the AATS 2014 definition, POAF occurred in 20% of ERAS patients vs. 39% in the pre-ERAS group (<i>p</i> = 0.001), and 23% vs. 39% in the matched cohort (<i>p</i> = 0.004). Using the ESC 2024 definition, POAF was observed in 21% vs. 37% (<i>p</i> = 0.001) in unmatched and 20% vs. 36% (<i>p</i> = 0.005) in matched populations. Compliance with POAF prophylaxis improved markedly in the ERAS group (70% vs. 21%, <i>p</i> = 0.001). ERAS patients also experienced shorter hospital stays and fewer postoperative complications (26% vs. 38% in the matched cohort, <i>p</i> = 0.033). <b>Conclusions</b>: The implementation of a structured ERAS protocol significantly reduced POAF incidence, improved compliance with preventive strategies, and enhanced key aspects of postoperative recovery. |
| format | Article |
| id | doaj-art-74515ae1ea8e4f8f929d2be95cf39087 |
| institution | DOAJ |
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| language | English |
| publishDate | 2025-05-01 |
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| spelling | doaj-art-74515ae1ea8e4f8f929d2be95cf390872025-08-20T03:14:30ZengMDPI AGBiomedicines2227-90592025-05-01135121210.3390/biomedicines13051212Effect of Enhanced Recovery After Surgery (ERAS) Implementation on Postoperative Atrial Fibrillation in Cardiac SurgeryRomain Niessen0Valentina Rancati1Mario Verdugo-Marchese2Ziyad Gunga3Anna Nowacka4Valentine Melly5Christophe Abellan6Karima Alouazen7Tamila Abdurashidova8Caroline Botteau9Matthias Kirsch10Zied Ltaief11Department of Intensive Care Medicine, Lausanne University Hospital (CHUV), 1011 Lausanne, SwitzerlandDepartment of Anesthesia, Lausanne University Hospital (CHUV), 1011 Lausanne, SwitzerlandDepartment of Cardiac Surgery, Lausanne University Hospital (CHUV), 1011 Lausanne, SwitzerlandDepartment of Cardiac Surgery, Lausanne University Hospital (CHUV), 1011 Lausanne, SwitzerlandDepartment of Cardiac Surgery, Lausanne University Hospital (CHUV), 1011 Lausanne, SwitzerlandDepartment of Cardiac Surgery, Lausanne University Hospital (CHUV), 1011 Lausanne, SwitzerlandDepartment of Intensive Care Medicine, Lausanne University Hospital (CHUV), 1011 Lausanne, SwitzerlandDepartment of Intensive Care Medicine, Lausanne University Hospital (CHUV), 1011 Lausanne, SwitzerlandDepartment of Cardiac Surgery, Lausanne University Hospital (CHUV), 1011 Lausanne, SwitzerlandDepartment of Cardio-Respiratory Physiotherapy, Lausanne University Hospital (CHUV), 1011 Lausanne, SwitzerlandDepartment of Cardiac Surgery, Lausanne University Hospital (CHUV), 1011 Lausanne, SwitzerlandDepartment of Intensive Care Medicine, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland<b>Background/Objectives</b>: Postoperative atrial fibrillation (POAF) is the most frequent arrhythmic complication following cardiac surgery and is associated with increased morbidity and prolonged recovery. This study aimed to evaluate the impact of an enhanced recovery after surgery (ERAS) program on the incidence of POAF and broader perioperative outcomes. <b>Methods</b>: In this monocentric, observational cohort study, we compared a retrospective pre-ERAS cohort (<i>n</i> = 162) with a prospective ERAS cohort (<i>n</i> = 321). The primary outcome was the incidence of POAF, assessed using two definitions: (1) the American Association for Thoracic Surgery (AATS) 2014 clinical definition, identifying POAF as atrial fibrillation requiring treatment; and (2) the European Society of Cardiology (ESC) 2024 definition, describing new-onset atrial fibrillation occurring immediately after surgery. Secondary outcomes included compliance with POAF prophylaxis measures, length of hospital stay, and the occurrence of postoperative complications. Statistical analyses included propensity score matching and multivariate logistic regression to identify independent predictors of POAF. <b>Results</b>: ERAS implementation was associated with a significant reduction in POAF incidence across both definitions. According to the AATS 2014 definition, POAF occurred in 20% of ERAS patients vs. 39% in the pre-ERAS group (<i>p</i> = 0.001), and 23% vs. 39% in the matched cohort (<i>p</i> = 0.004). Using the ESC 2024 definition, POAF was observed in 21% vs. 37% (<i>p</i> = 0.001) in unmatched and 20% vs. 36% (<i>p</i> = 0.005) in matched populations. Compliance with POAF prophylaxis improved markedly in the ERAS group (70% vs. 21%, <i>p</i> = 0.001). ERAS patients also experienced shorter hospital stays and fewer postoperative complications (26% vs. 38% in the matched cohort, <i>p</i> = 0.033). <b>Conclusions</b>: The implementation of a structured ERAS protocol significantly reduced POAF incidence, improved compliance with preventive strategies, and enhanced key aspects of postoperative recovery.https://www.mdpi.com/2227-9059/13/5/1212atrial fibrillationpostoperative atrial fibrillationenhanced recovery after surgerycardiac surgeryperioperative medicine |
| spellingShingle | Romain Niessen Valentina Rancati Mario Verdugo-Marchese Ziyad Gunga Anna Nowacka Valentine Melly Christophe Abellan Karima Alouazen Tamila Abdurashidova Caroline Botteau Matthias Kirsch Zied Ltaief Effect of Enhanced Recovery After Surgery (ERAS) Implementation on Postoperative Atrial Fibrillation in Cardiac Surgery Biomedicines atrial fibrillation postoperative atrial fibrillation enhanced recovery after surgery cardiac surgery perioperative medicine |
| title | Effect of Enhanced Recovery After Surgery (ERAS) Implementation on Postoperative Atrial Fibrillation in Cardiac Surgery |
| title_full | Effect of Enhanced Recovery After Surgery (ERAS) Implementation on Postoperative Atrial Fibrillation in Cardiac Surgery |
| title_fullStr | Effect of Enhanced Recovery After Surgery (ERAS) Implementation on Postoperative Atrial Fibrillation in Cardiac Surgery |
| title_full_unstemmed | Effect of Enhanced Recovery After Surgery (ERAS) Implementation on Postoperative Atrial Fibrillation in Cardiac Surgery |
| title_short | Effect of Enhanced Recovery After Surgery (ERAS) Implementation on Postoperative Atrial Fibrillation in Cardiac Surgery |
| title_sort | effect of enhanced recovery after surgery eras implementation on postoperative atrial fibrillation in cardiac surgery |
| topic | atrial fibrillation postoperative atrial fibrillation enhanced recovery after surgery cardiac surgery perioperative medicine |
| url | https://www.mdpi.com/2227-9059/13/5/1212 |
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