The reduction in hospital stay and costs in the care of patients with congenital heart diseases undergoing fast-track cardiac surgery.
OBJECTIVE
To assess the care provided to patients with congenital heart diseases and ischemic heart diseases undergoing cardiac surgery according to the fast-track recovery protocol compared with those undergoing the conventional procedure.


METHODS
The transfer of patients from one hospital unit to another was assessed for 175 patients, 107 (61%) men and 68 (39%) women, with ages ranging from 0.3 to 81 years.


RESULTS
The discharge rate from the different hospital units per unit of time of the patients with congenital heart diseases treated according to the fast-track recovery protocol compared with that of patients conventionally treated was as follows: a) 11.3 times faster than the discharge rate of patients treated according to the conventional protocol, in regard to the time spent in the operating room; b) 6.3 times faster in regard to the duration of the surgical intervention; c) 6.8 times faster in regard to the duration of anesthesia; d) 1.5 times faster in regard to the duration of perfusion; e) 2.8 times faster in regard to the stay in the postoperative recovery I unit; f) 6.7 times faster in regard to hospital stay (time period between hospital admission and hospital discharge); g) 2.8 times faster in regard to the stay in the preoperative unit; h) 2.1 times faster in regard to the stay in the admission unit after discharge from postoperative recovery; i) associated with reduced costs. The difference was not significant for patients with ischemic heart disease.


CONCLUSIONS
A reduction in the length of hospital stay and costs for the care of patients undergoing cardiac surgery according to the fast-track protocol was observed.
Instituto do Coração, Hospital das Clínicas, FMUSP, São Paulo, SP, Brazil. alfredo.fernandes@hcnet.usp.br
Alfredo Manoel da Silva
AM
Fernandes
Alfredo José
AJ
Mansur
Luis Fernando
LF
Canêo
Domingos Dias
DD
Lourenço
Marilde Albuquerque
MA
Piccioni
Sonia Mieken
SM
Franchi
Cristina Machado C
CM
Afiune
Jorge Wiliam
JW
Gadioli
Sérgio de Almeida
Sde A
Oliveira
José Antonio Franchini
JA
Ramires
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery*; D010360:Patient Transfer; D011182:Postoperative Care / Q000191:economics*; D011183:Postoperative Complications; D011997:Recovery Room / Q000191:economics*; D012306:Risk; D016896:Treatment Outcome