Table 1.
List of the full-text papers included in the review summarising patients’ characteristics, postoperative outcomes and key findings associated with the ERAS approach.
| Author(s), Year | Study Period | Patients | Age (Years) |
Sex (F/M) | Type of Valve Surgery | Mortality | Stroke | AKI | Postoperative AF | Time of Mechanical Ventilation (Hours) | ICU LOS (Hours) | Hospital LOS (Days) | Other(s) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Li et al., 2018 RCT [15] |
2015–2016 | 104 ERAS | 51.0 ± 10.1 (25.0–69.0) | 53/51 | Aortic n = 11 (10.58%), mitral n = 11 (10.58%) | 0 | 0 | 2 (1.9%) | 4 (3.8%) | 7.2 (0.0–22.3) | 20.9 (13.5–69.3) | 6.0 (2.0–14.0) | ICU readmission 1 vs. 1 (ERAS vs. control) Reintubation 0 vs. 1 (ERAS vs. control) |
| 105 control | 52.2 ± 10.4 (23.0–69.0) | 56/49 | Aortic n = 17 (16.19%), mitral n = 8 (7.62%) | 0 | 1 (0.9%) | 3 (2.9%) | 12 (11.4%) | 8.8 (3.7–44.9) | 22.0 (13.4–212.3) | 7.0 (4.0–16.0) | |||
| p = 0.36 | p = 0.79 | - | - | - | p = 0.04 | p < 0.0001 | p = 0.001 | p = 0.07 | |||||
| Blitzer et al., 2022 OS [16] |
2019–2020 | 34 ERAS | 51.7 ± 14.83 | 9/34 | Valve surgery n = 15 (18%) | 1 (3%) | 0 | - | 5 (15%) | 70.6 ± 287.0 | 165 ± 312 | 15.4 ± 14.7 | |
| 49 control | 54.3 ± 13.6 | 19/30 | 1 (2%) | 0 | - | 6 (12%) | 59.3 ± 136.6 | 165 ± 192 | 16.8 ± 14.4 | ||||
| p = 0.41 | p = 0.24 | p = 0.79 | - | - | p = 0.75 | p = 0.81 | p = 0.99 | p = 0.66 | |||||
| Hendy et al., 2022 OS [17] |
2019–2020 vs. 2017 | 100 ERAS | 63.0 ± 10.7 | 18/82 | Aortic n = 26 (26%), mitral n = 5 (5%) | 0 | 0 | 0 | 13 (13%) | 6.7 ± 1.6 | - | 5.1 ± 1.3 vs. | Time to ambulation (hours) 9.78 ± 2.03 vs. 40.43 ± 46.70 (ERAS vs. control) p < 0.001 |
| 103 control | 64.1 ± 9.7 | 34/69 | Aortic n = 26 (25%), mitral n = 3 (2.9%) | 0 | 1 (0.97%) | 0 | 15 (14.6%) | 14.7 ± 33.1 | - | 8.9 ± 3.5 | |||
| p = 0.04 | p = 0.02 | - | - | p = 1 | - | p = 1 | p < 0.001 | - | p < 0.001 | ||||
| Fleming et al., 2016 OS [18] |
2010–2011 | 52 ERAS | 68.6 ± 11.1 | 14/38 | Aortic n = 5 (9.6%), mitral n = 7 (13.5%) | 1 (1.9%) | 0 | 2 (3.8%) | 7 (13.5%) | - | - | 6 (4–7) | First postoperative intake of enteral solids day 1: 42 (80.1%) vs. 29 (54.7%) (ERAS vs. control) p = 0.007 |
| 53 control | 66.5 ± 11.8 | 15/38 | Aortic n = 8 (15.1%), mitral n = 3 (5.7%) | 2 (3.8%) | 2 (3.8%) | 6 (7.5%) | 15 (28.3%) | - | - | 6 (5–9) | |||
| p = 0.34 | p = 0.87 | p = 0.71 | p = 0.57 | p = 0.16 | p = 0.27 | p = 0.06 | - | - | p = 0.31 | ||||
| Williams et al., 2019 OS [19] |
2017 | 443 ERAS | 65 vs. 65 (ERAS vs. control) | 31/34 | Mitral/tricuspid = 15%, aortic = 17% | - | - | - | - | 5.3 (3.9–6.9) | 28 (23–52) | 6 (5–8) | GI complications 3.6% vs. 6.8% (ERAS vs. control) (p = 0.04) |
| 489 control | 65 | 31/34 | - | - | - | - | 5.2 (3.9- 7.3) | 43 (25–74) | 7 (5–9) | ||||
| - | - | - | - | - | - | p = 0.53 | p < 0.01 | p < 0.01 | |||||
| Zaouter et al., 2019 OS [20] |
2014–2015 | 23 ERAS | 80 (74–82) | 14/9 | Aortic valve (mini-sternotomy) | - | - | 0 | 9 (39%) | - | 24 (24–28) | 7 (6.5–8) | Pulmonary infection 2 (9%) vs. 7 (30%) (ERAS vs. control) p = 0.06 |
| 23 control | 73 (68–82) | 7/16 | - | - | 2 (9%) | 6 (26%) | - | 28 (25–47) | 10 (9–13.5) | ||||
| p = 0.16 | p = 0.04 | - | - | p = 0.15 | p = 0.35 | - | p = 0.003 | p < 0.001 | |||||
| Petersen et al., 2021 OS [21] |
2018–2019 | 61 ERAS | 50.7 ± 12.9 | 14/47 | Aortic n = 37 (61%), mitral n = 24 (39%) | 0 | - | - | - | - | 26.5 ± 25.2 | 6.1 ± 2.6 | |
| 69 control | 54.1 ± 9.5 | 17/52 | Aortic n = 35 (51%), mitral n = 34 (49%) | 0 | - | - | - | - | 46.6 ± 44.9 | 7.7 ± 3.8 | |||
| p = 0.09 | p = 0.81 | p = 0.26 | - | - | - | - | - | p = 0.01 | 0.008 | ||||
| Yazdchi et al., 2021 OS [22] |
2017–2019 | 76 ERAS | 62.7 ± 9.7 | 25/51 | Aortic n = 22 (29%), mitral n = 14 (19%) | 0 | 0 | 0 | 11 (14.5%) | 3.5 (3.1–4.7) | 28 (23–47) | 5 (4–7) | Reoperation for bleeding 0 vs. 0 (ERAS vs. control) |
| 76 control | 63.2 ± 12.8 | 25/51 | Aortic n = 21 (28%), mitral n = 12 (16%) | 0 | 1 (1.3%) | 1 (1.3%) | 20 (26.3%) | 5.3 (3.7–7.5) | 48 (26–69) | 6 (5–8) | |||
| 0.76 | p = 1 | p = 0.4 | - | p = 1 | p = 1 | p = 0.1 | p = 0.01 | p = 0.005 | p = 0.03 | ||||
| Bills et al., 2022 OS [23] |
2019–2020 | 133 ERAS | 65 (60–72) | 41/92 | All valve procedures | - | - | - | - | 10.8 (9.3–12.9) | - | 5.8 (4.9–7.1) | Opioid-related complications ERAS 57% vs. control 63% |
| 185 control | 65 (58–71) | 54/131 | - | - | - | - | 8.85 (7.3–10.3) | - | 6.1 (5–8) | ||||
| p = 0.59 | p = 0.66 | - | - | - | - | p = 0.47 | - | p = 0.89 | |||||
| Loria, 2022 OS [24] |
2018 vs. 2020 | 216 ERAS | 62 (51–70) | 83/167 | Valve n = 54 (22%) | 8 (3.2%) | 2 (0.8%) | 8 (3.2%) | 69 (27.6%) | 4.9 | 74 | 6.5 | Chest tube removal postoperative day 3 vs. 4 (ERAS vs. control) p < 0.0001) |
| 250 control | 64 (57–70) | 66/150 | Valve n = 65 (30.1%) | 5 (2.3%) | 1 (0.5%) | 6 (2.8%) | 62 (28.7%) | 4.7 | 3.3 | 6 | |||
| p = 0.13 | p = 0.54 | p < 0.001 | p = 0.77 | p > 0.99 | p = 0.79 | p = 0.79 | p = 0.54 | p = 0.3 | p = 0.5 | ||||
| Gebauer et al., 2023 OS [25] |
2018–2020 | 101 ERAS | 56 ± 17 | 27/74 | Aortic n = 51 (52%), Mitral n = 49 (49%) | - | 2 (2%) | - | 25 (24.8%) | - | 18.5 ± 6 | 7 ± 3 | - |
| 111 control | 57.5 ± 13 | 32/79 | Aortic n = 49 (44%), mitral n = 62 (56%) | - | 2 (1.8%) | - | 17 (15.3%) | - | 26.5 ± 29 | 8 ± 4 | |||
| p = 0.015 | p = 0.73 | p = 0.28 | - | - | p = 0.08 | - | p < 0.01 | p < 0.01 | |||||
| Giger et al., 2023 OS [26] |
2015–2018 vs. 2018–2020 | 259 ERAS | 69.7 ± 8.3 | 111/148 | Aortic valve | 1 (0.4%) | 1 (0.2%) | 5 (1.9%) | 84 (32%) | 6.9 ± 25 | 1.7 ± 1.8 | 7.7 ± 6.7 | Mechanical ventilation time < 6 h 87% vs. 65% (ERAS vs. control) p < 0.001 Delirium 4 (1.5%) vs. 14 (5.4%) (ERAS vs. control) p = 0.028 |
| 229 control | 70.4 ± 9.7 | 114/115 | 1 (0.4%) | 2 (0.4%) | 1 (0.4%) | 88 (34%) | 6.5 ± 3.9 | 2.2 ± 3.1 | 7.4 ± 4.5 | ||||
| p = 0.39 | 0.79 | p = 1 | p = 0.56 | p = 0.1 | p = 0.79 | p = 0.86 | p = 0.039 | p = 0.5 | |||||
| Obafemi et al., 2023 OS [27] |
2017–2018 | 747 ERAS | 68.7 (61–75) | 157/590 | Aortic valve | 25 (3.3%) | - | - | - | 23.5 (9.6–122.6) | 54.0 (40.4–97.0) | 6.0 (4.9–8.8) | Days to first ambulation 1.6 (1.5–2.6) vs. 2.3 (1.6–3.5) (ERAS vs. Control) p < 0.001 |
| 747 control |
67.3 (59–75) | 165/582 | 30 (4%) | - | - | - | 272.4 (22.2–839.9) | 69.9 (40.8–116.7) | 7.0 (5.2–11.0) | ||||
| p = 0.16 | p = 0.61 | p = 0.47 | - | - | - | p < 0.001 | p = 0.01 | p < 0.001 | |||||
| Berretta et al., 2023 OS [28] |
2016–2020 | 152 ERAS | 69.6 ± 11.1 | 84/78 | Aortic n = 108 (71%) Mitral n = 44 (29%) |
0 | 0 | 2 (1.3%) | 41 (27%) | 0 | 30 (24–52) | 6 (5–7.7) | Respiratory insufficiency 1 (0.7%) vs. 5 (3.3%) (ERAS vs. Control) p = 0.04 |
| 152 control | 70 ± 11.9 | 78/84 | Aortic n = 107 (70%) Mitral n = 45 (30%) |
1 (0.7%) | 2 (1.3%) | 5 (3.3%) | 49 (32.3%) | 6 (4–9) | 40 (24–59) | 7 (6–8) | |||
| - | - | p = 0.9 | p = 0.5 | p = 0.4 | p = 0.4 | p < 0.001 | p = 0.003 | p = 0.04 |
AF: atrial fibrillation, AKI: acute kidney injury, ICU: intensive care unit, OS: observational study, RCT: randomised controlled trial.