Cardiac Surgery, Frailty, Nutritional Risk
Conditions
Keywords
Enhanced Recovery After Surgery, ERAS Compliance, Prognostic Nutritional Index, NRS-2002, Clinical Frailty Scale, Open Heart Surgery
Brief summary
This prospective observational study will evaluate the association between compliance with an Enhanced Recovery After Surgery (ERAS) protocol and length of hospital stay in 120 adults undergoing elective open heart surgery. Secondary outcomes will include nutritional status, postoperative complications, intensive care unit stay, 30-day readmission, and mortality.
Detailed description
This single-center, prospective observational study will include 120 adults undergoing elective open heart surgery. Participants will receive routine perioperative care without any research-specific intervention. ERAS compliance will be calculated and classified as high (≥80%), moderate (60-79%), or low (\<60%). The primary outcome will be length of hospital stay. Secondary outcomes will include changes in NRS-2002 and PNI, postoperative complications, intensive care unit stay, 30-day readmission, and mortality.
Interventions
OTHERERAS Protocol Compliance Assessment
Compliance with applicable preoperative, intraoperative, and postoperative ERAS components will be recorded without altering routine clinical care. Each implemented component will be scored as 1 and each non-implemented component as 0. Overall compliance will be calculated as the percentage of applicable components implemented. No study-specific therapeutic intervention will be assigned.
Sponsors
Bursa City Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Aged 18 to 85 years * Scheduled to undergo elective open heart surgery through median sternotomy under general anesthesia * Able to provide written informed consent
Exclusion criteria
* Emergency cardiac surgery * Preoperative total parenteral nutrition * End-stage renal disease or severe hepatic failure * Uncontrolled metabolic disease, including uncontrolled diabetes mellitus or hypertension * Active infection * Cognitive or mental impairment preventing valid informed consent * Pregnancy, suspected pregnancy, or breastfeeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Length of Hospital Stay | From the date of surgery to hospital discharge, up to 60 days | Length of hospital stay will be defined as the number of calendar days from the date of surgery to hospital discharge. The duration will be calculated for each participant and compared among the high, moderate, and low ERAS compliance cohorts. A shorter hospital stay indicates earlier postoperative recovery and discharge. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Prognostic Nutritional Index | From the preoperative assessment to 48 hours after surgery | The Prognostic Nutritional Index (PNI) will be calculated as: (10 × serum albumin \[g/dL\]) + (0.005 × total lymphocyte count \[/mm³\]). Higher scores indicate better nutritional and immunological status. The change from the preoperative value to the postoperative 48-hour value will be compared among the ERAS compliance cohorts. |
| Incidence of Postoperative Complications | From surgery until hospital discharge, up to 30 days | Number and percentage of participants who develop at least one postoperative complication, including infection, atrial fibrillation, acute kidney injury, or respiratory complications. Complications will be identified from routine clinical records and compared among the ERAS compliance cohorts. |
| Change in Nutritional Risk Screening 2002 Score | From the preoperative assessment to 48 hours after surgery | Nutritional risk will be assessed using the Nutritional Risk Screening 2002 (NRS-2002). The score incorporates impaired nutritional status, disease severity, and an additional point for participants aged 70 years or older. Total scores range from 0 to 7, with higher scores indicating greater nutritional risk. A score of 3 or higher indicates the presence of nutritional risk. The primary outcome is the change in NRS-2002 score from the preoperative assessment to 48 hours after surgery. Changes will be compared among the high, moderate, and low ERAS compliance cohorts. |
Countries
Turkey (Türkiye)
Outcome results
None listed