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Thorac Cardiovasc Surg 2022; 70(05): 405-412
DOI: 10.1055/s-0041-1727232
Original Thoracic

Delayed Discharge after Thoracic Surgery under the Guidance of ERAS Protocols

Lei Liu
1   Department of Thoracic Surgery, Peking Union Medical College Hospital, Dongcheng-qu, Beijing, People's Republic of China
,
Jiaqi Zhang
1   Department of Thoracic Surgery, Peking Union Medical College Hospital, Dongcheng-qu, Beijing, People's Republic of China
,
Guige Wang
1   Department of Thoracic Surgery, Peking Union Medical College Hospital, Dongcheng-qu, Beijing, People's Republic of China
,
Chao Guo
1   Department of Thoracic Surgery, Peking Union Medical College Hospital, Dongcheng-qu, Beijing, People's Republic of China
,
Yeye Chen
1   Department of Thoracic Surgery, Peking Union Medical College Hospital, Dongcheng-qu, Beijing, People's Republic of China
,
Cheng Huang
1   Department of Thoracic Surgery, Peking Union Medical College Hospital, Dongcheng-qu, Beijing, People's Republic of China
,
Shanqing Li 
1   Department of Thoracic Surgery, Peking Union Medical College Hospital, Dongcheng-qu, Beijing, People's Republic of China
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Abstract

Background Enhanced recovery after surgery (ERAS) protocols have been applied in thoracic surgery and are beneficial to patients. However, some issues about ERAS are still pending.

Methods A total of 1,654 patients who underwent thoracic surgery under the guidance of ERAS protocols were enrolled in this study. We set the length of postoperative stay (LOPS) as our key research indicator. Patients were divided into routine discharge group and delayed discharge group based on LOPS. Causes of delayed discharge were analyzed to improve management of postoperative recovery.

Results Male, old age, underlying disease (coronary artery disease, chronic kidney disease, old cerebral infarction, chronic obstructive pulmonary disease, and arrhythmia), intensive care unit (ICU) stay, type of insurance, and lower forced expiratory volume in one second (FEV1) are the independent impact factors causing delayed discharge. Increased nonchylous drainage (INCD) and prolonged air leakage were the two leading causes for delayed discharge.

Conclusion Patients should have personalized recovery goal under the same ERAS protocols. We should accept that patients in poor general condition have a prolonged LOPS. More stringent ICU stay indications should be developed to increase postoperative patients' ERAS protocols compliance. Further research on chest tube management will make a contribution to ERAS protocols.

Keywords

thoracic surgery - enhanced recovery after surgery - hospital stay - chest tube management


Publication History

Received: 03 October 2020

Accepted: 12 February 2021

Article published online:
27 June 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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