- Enhanced recovery after cardiac surgery protocols to reduce hospital stay and morbidity rates
1Imran Khan Khalil, 2Nasir Islam, 3Dr Sajid Khan, 4Aitizaz Ahsan
1Consultant cardiac surgeon, MMC General Hospital Peshawar
2Consultant Cardiac Surgeon, Fauji foundation hospital Peshawar, Consultant Cardiac Surgeon Peshawar
General Hospital (Corresponding)
3Consultan Mti HMC Peshawar
4Registrar Cardiac Surgery
Submission: 05 December 2025 | Acceptance: 20 December 2025 | Publication: 29 December 2025
Vol: 04, Issue: 02
ABSTRACT:
Background: Enhanced Recovery After Cardiac Surgery (ERACS) guidelines have been created to maximize perioperative practice by applying evidence-based interventions to reduce the effects of surgical stress, hasten the recovery period, and lessen the occurrence of complications. Although there is evidence of practices that have been shown to be effective in other areas of surgery, not much local data was available on the efficacy of ERACS protocols in cardiac surgery in tertiary care hospitals in Pakistan.
Purpose: The purpose of the study was to determine the effect of enhanced recovery after cardiac surgery protocols on both the hospital length of stay and postoperative morbidity of patients undergoing cardiac surgery.
Methods: The study was a descriptive one and was carried out at Pakistan Institute of Medical Sciences (PIMS), Islamabad, in the period between October 2024 and September 2025. There were 90 subjects included in the study as adults that were undergoing elective heart surgery. Patients were dealt with as per the-standardized ERACS guidelines that involved preoperative counseling, optimal analgesia, early estuations, early mobilization and early introduction of oral feeding. It was done to obtain the information on demographic data, surgery type, stay length, and postoperative conditions including wound contamination, atrial fibrillation, respiratory issues, and re-hospitalization. Descriptive statistical analysis techniques were used when analyzing the collected data.
Results: The patients were of mean age 55.324.6, mostly men. ERACS protocol implementation showed the mean hospital stay of 6.2 days as reduced to 6.2 ±1.8 days. The postoperative morbidity reported was 22.2% with the atrial fibrillation (10.0%) and respiratory complications (6.7) having the highest frequencies. Four and point four percent of cases reported wound infections and 3.3 percent of patients had re-admission within 30 days. The general recovery rate was accelerated and the vast majority of patients became able to get out of the bed without any significant adverse event.
Conclusion: The use of the protocols of enhanced recovery after the cardiac surgery was linked to a shorter stay at the hospital and a decrease in the postoperative morbidity. These results indicated that ERACS protocols were safe, practical and effective intervention in enhancing postoperative outcomes in cardiac surgery patients and must be recommended to be routinely applied in tertiary care units.
Keywords: Enhanced recovery, cardiac surgery, hospital stay, postoperative morbidity, ERACS protocols, perioperative care.