• Zakhary Waseem, Jacob Lindner, Sophia Sgouropoulou, Sarah Eibel, Stefan Probst, Markus Scholz, and Joerg Ender.
• Department of Anesthesiology and Intensive Care Medicine, Heart Center, University Leipzig, Leipzig, Germany. Electronic address: WaseemZakariaAziz.Zakhary@medizin.uni-leipzig.de.
• J. Cardiothorac. Vasc. Anesth. 2015 Dec 1; 29 (6): 1461-5.

ObjectisvesThe purpose of this study was to identify the independent risk factors for fast-track failure (FTF) in cardiac surgery patients.DesignA retrospective analysis.SettingA university-affiliated heart center.ParticipantsIn a 2-year period, 1,704 consecutive preselected patients undergoing elective cardiac surgery were treated according to the local fast-track protocol in the postanesthetic care unit (PACU), bypassing the intensive care unit (ICU).Measurements And ResultsIndependent risk factors for FTF in the univariate regression analysis were tested in a multivariate regression analysis. FTF was defined as any transfer of the preselected patient to the ICU. FTF was primary when the patient was transferred directly from the postanesthetic care unit to the ICU and secondary when the patient was transferred from the intermediate care unit or ward to the ICU. FTF rate was 11.6% for primary and 5.6% for secondary FTF. In the multivariate regression analysis, age>70 years, female sex, prolonged surgery, and prolonged cross-clamp time could be defined as independent risk factors for FTF.ConclusionsIn a preselected patient population, fast-track treatment could be done with a low FTF rate. Independent risk factors for FTF are age, female sex, prolonged surgery, and prolonged cross-clamp time.Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

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