Effectiveness of an Information Platform-Based Multidisciplinary Enhanced Recovery After Surgery Program on Recovery After Transcatheter Aortic Valve Implantation: A Non-Concurrent Controlled Study.

AIM: To evaluate the implementation effectiveness of a multicomponent multidisciplinary Enhanced Recovery After Surgery pathway integrated with an information platform for patients undergoing transcatheter aortic valve implantation.

DESIGN

A single-center quasi-experimental study with a non-concurrent historical control group.

METHODS

A single-center quasi-experimental study with a non-concurrent historical control group included 154 patients. Outcomes were assessed using a study-specific transcatheter aortic valve implantation knowledge questionnaire, the Fried frailty phenotype, Barthel Index, 12-Item Short Form Health Survey, 6-min walk test, left ventricular ejection fraction and hospital length of stay. Between-group comparisons used independent-samples t-tests, Mann-Whitney U tests and χ2 tests, as appropriate. Post hoc gamma regression and generalized estimating equations were used in sensitivity analyses addressing measurable temporal differences between treatment periods.

RESULTS

Patients treated after pathway implementation showed greater procedural knowledge, less postoperative frailty, greater functional independence, shorter hospitalization and more favourable functional and health-status outcomes. The association with shorter hospitalization persisted after adjustment for measured patient and procedural characteristics, whereas the longitudinal difference in left ventricular systolic function was attenuated after adjustment.

CONCLUSION

Implementation of the multicomponent pathway was associated with better functional recovery and shorter hospitalization after transcatheter aortic valve implantation. Component-specific effects and residual temporal confounding cannot be excluded.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Extending structured education and rehabilitation support from hospital to home may help nurses coordinate recovery and continuity of care after transcatheter aortic valve implantation.

IMPACT: This study provides implementation evidence for a digitally supported multidisciplinary recovery pathway after transcatheter aortic valve implantation.

REPORTING METHOD: The study was reported in accordance with the Transparent Reporting of Evaluations with Nonrandomized Designs statement.

PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution to the design, analysis, interpretation, or preparation of this study.