Effect of enhanced recovery after surgery (ERAS) programs on perioperative outcomes in patients undergoing cardiac surgery: A systematic review and meta-analysis

•There is limited evidence on the effectiveness of ERAS in cardiac surgery.•We performed a systematic review and meta-analysis of ERAS programs.•ERAS may reduce hospital stay, without affecting mortality or atrial fibrillation.•There are insufficient data to analyze quality of life.•The quality of t...

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Published in:Journal of cardiothoracic and vascular anesthesia 2025-01
Main Authors: Diz-Ferreira, Eva, Díaz-Vidal, Pablo, Fernández-Vázquez, Uxía, Gil-Casado, Cristina, Luna-Rojas, Pedro, Diz, José Carlos
Format: Article
Language:English
Subjects:
Anesthesia, Cardiac
Enhanced Recovery After Surgery
Patient-Centered Outcomes
Perioperative Care
Postoperative Complications
Surgery, Cardiac
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Summary:•There is limited evidence on the effectiveness of ERAS in cardiac surgery.•We performed a systematic review and meta-analysis of ERAS programs.•ERAS may reduce hospital stay, without affecting mortality or atrial fibrillation.•There are insufficient data to analyze quality of life.•The quality of the evidence is low, so more randomized trials are needed. Enhanced Recovery After Surgery (ERAS) programs emerged as a strategy to reduce perioperative morbidity; however, there is currently limited evidence of their clinical efficacy. The objective of this study was to assess the impact of ERAS programs in cardiac surgery on hospital length of stay, mortality, atrial fibrillation and quality of life. A systematic review and meta-analysis was conducted in accordance with the PRISMA statement, encompassing studies on ERAS programs in adult patients undergoing elective cardiac surgery. The effect size and 95% CI were estimated with a random-effects model. The protocol was pre-registered on OSF. Eighteen studies (published between 2016 and 2023) comprising 4,469 patients were included in the analysis, of which only one was a randomized controlled trial. The implementation of ERAS was associated with a reduction in hospital stay of 1.24 days (95% CI: -1.67, -0.82; p
ISSN:1053-0770
DOI:10.1053/j.jvca.2025.01.036