Fast-Track Anesthesia and Cardiac Surgery: A Retrospective Cohort Study of 7989 Patients

BACKGROUND: Fast-track cardiac anesthesia (FTCA) has been widely implementedbut its safety has not been evaluated in sufficiently powered studies.METHODS: We compared outcomes of patients undergoing FTCA with a historicalcontrol group undergoing conventional high-dose opioid cardiac anesthesia(CCA). The primary outcome measure was the incidence of in-hospital mortality.Secondary outcome measures were the incidence of in-hospital acute myocardialinfarction, renal failure, and stroke. We also compared duration of mechanicalventilation and length of hospitalization in the intensive care unit and postopera-tive ward.RESULTS: The CCA group comprised 4020 patients and the FTCA Group 3969patients. The patients in the FTCA group were slightly older, had more comor-bidities, and were more likely to undergo valve surgery than the CCA group. Theincidence of in-hospital mortality was 1.9% in the CCA group and 2.3% in theFTCA group. Compared with the CCA group, the crude odds ratio for mortality inthe FTCA group was 1.20 (95% confidence interval 0.88–1.64,