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Ann Thorac Surg 1997;64:706-709
© 1997 The Society of Thoracic Surgeons
Cardiothoracic Section, Department of Surgery, Guthrie Clinic, Sayre, Pennsylvania
Accepted for publication March 28, 1997.
Background. In this study we determine retrospectively whether assignment of all patients undergoing coronary artery bypass grafting to a "fast-track" protocol (FT) is practical and realistic in our rural institution.
Methods. We compared the outcome of 266 consecutive patients undergoing coronary artery bypass grafting who were fast-tracked in 1996 with that of 266 consecutive patients who were managed conventionally (NFT) in 1994. The surgical techniques were comparable in both groups; however, FT anesthesia used inhalational agents and short-acting narcotics. All comparisons were performed using the Student's t test or the 
2 test.
Results. Postoperatively 95% of the FT group were extubated by 24 hours compared with 0% in the NFT group (p< 0.0001). The mean intensive care unit length of stay in the FT group was 1.7 ± 0.8 days, whereas it was 2.6 ± 0.6 days in the NFT group (p< 0.001). The mean postoperative length of stay was 6.4 ± 1.2 days in the FT group compared with 7.5 ± 0.9 days in the NFT group (p< 0.001). There were no significant differences in 30-day morbidity/mortality. There was a substantial cost savings in the FT group.
Conclusions. The fast-track protocol can be successful without any compromise of patient care. Early discharge from the hospital, however, is not always feasible.
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