Ashenhurst Christine, Toubar Omar, Ponnambalam Menaka, Masters Roy, Guo Ming Hao, Issa Hugo, Ruel Marc
Division of Cardiac Surgery, University of Ottawa Heart Institute, ON, Canada.
Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Innovations (Phila). 2025 Jul-Aug;20(4):350-358. doi: 10.1177/15569845251361492. Epub 2025 Jul 31.
To evaluate the impact of a novel multidisciplinary initiative, known as the Multimodal ENhanced Discharge (MEND), on length of stay (LOS) for patients undergoing minimally invasive coronary artery bypass grafting (MICS CABG).
The MEND program aims to optimize the patient's preoperative condition and increase preparedness, provide individualized perioperative care, and ensure early postdischarge follow-up to support active recovery and facilitate early discharge. This single-center, retrospective analysis reviewed LOS and readmission data for 198 consecutive patients who underwent MICS CABG by a single surgeon. Of these, 91 patients received routine care (RC) and 107 patients received care through the MEND program.
The median ward (non-intensive care unit) LOS was significantly shorter by 33% in the MEND group versus the RC group (2 vs 3 days, < 0.001), resulting in a 40% shorter median total hospital LOS in the MEND group versus the RC group (2 vs 5 days, < 0.001). Readmission rates were 14.3% for RC and 6.6% in the MEND group ( = 0.12).
Implementation of the MEND program in patients undergoing MICS CABG was associated with significantly shorter overall hospital LOS without an increase in readmission rates. No statistically significant differences in baseline characteristics between the RC and MEND cohorts were observed. These findings suggest MEND is an effective and generalizable program for optimizing recovery. Ultimately, this model of care has the potential to positively affect health care costs, improve surgical wait times, and expand capacity in MICS CABG programs.
评估一项名为多模式强化出院（MEND）的新型多学科举措对接受微创冠状动脉旁路移植术（MICS CABG）患者住院时间（LOS）的影响。
MEND计划旨在优化患者术前状况并提高准备程度，提供个性化围手术期护理，并确保出院后早期随访以支持积极康复并促进早期出院。这项单中心回顾性分析回顾了由一名外科医生连续进行MICS CABG手术的198例患者的住院时间和再入院数据。其中，91例患者接受常规护理（RC），107例患者通过MEND计划接受护理。
MEND组的中位病房（非重症监护病房）住院时间比RC组显著缩短33%（2天对3天，<0.001），导致MEND组的中位总住院时间比RC组缩短40%（2天对5天，<0.001）。RC组的再入院率为14.3%，MEND组为6.6%（P = 0.12）。
在接受MICS CABG手术的患者中实施MEND计划与显著缩短总住院时间相关，且再入院率没有增加。在RC组和MEND组之间未观察到基线特征的统计学显著差异。这些发现表明MEND是一个优化康复的有效且可推广的计划。最终，这种护理模式有可能对医疗成本产生积极影响，改善手术等待时间，并扩大MICS CABG项目的容量。
