A STEPPED-WEDGE CLUSTER RANDOMIZED TRIAL TO ASSESS THE IMPACT OF HEALTHCARE APP ON LENGTH OF STAY AFTER CORONARY ARTERY BYPASS GRAFT SURGERY: REPLICCAR III

• Grant number: 23/05673-5
• Support Opportunities: Regular Research Grants
• Start date: February 01, 2024
• End date: January 31, 2026
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Omar Asdrúbal Vilca Mejía
• Grantee: Omar Asdrúbal Vilca Mejía
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated researchers: Fabio Biscegli Jatene ; Luis Alberto Oliveira Dallan ; Luiz Augusto Ferreira Lisboa
• Associated scholarship(s): 25/00830-0 - A STEPPED-WEDGE CLUSTER RANDOMIZED TRIAL TO ASSESS THE IMPACT OF HEALTHCARE APP ON LENGTH OF STAY AFTER CORONARY ARTERY BYPASS GRAFT SURGERY: REPLICCAR III, BP.TT; 24/22861-2 - A STEPPED-WEDGE CLUSTER RANDOMIZED TRIAL TO ASSESS THE IMPACT OF HEALTHCARE APP ON LENGTH OF STAY AFTER CORONARY ARTERY BYPASS GRAFT SURGERY: REPLICCAR III, BP.TT; 24/17570-9 - A STEPPED-WEDGE CLUSTER RANDOMIZED TRIAL TO ASSESS THE IMPACT OF HEALTHCARE APP ON LENGTH OF STAY AFTER CORONARY ARTERY BYPASS GRAFT SURGERY: REPLICCAR III, BP.TT; 24/18642-3 - A STEPPED-WEDGE CLUSTER RANDOMIZED TRIAL TO ASSESS THE IMPACT OF HEALTHCARE APP ON LENGTH OF STAY AFTER CORONARY ARTERY BYPASS GRAFT SURGERY: REPLICCAR III, BP.TT; 24/17518-7 - A STEPPED-WEDGE CLUSTER RANDOMIZED TRIAL TO ASSESS THE IMPACT OF HEALTHCARE APP ON LENGTH OF STAY AFTER CORONARY ARTERY BYPASS GRAFT SURGERY: REPLICCAR III, BP.TT

Abstract

Cardiovascular diseases remain the leading cause of death in the world. Among them, coronary artery disease is the one with the greatest impact, being characterized as one of the main causes of death in Brazil in the last decade. One of the well-established treatments is myocardial revascularization surgery, the most performed within cardiac surgeries, and which in our scenario are mostly financed by the Sistema Único de Saúde (SUS). The information obtained from the Registro Paulista de Cirurgia Cardiovascular (REPLICCAR), in partnership with FAPESP, has been important for the implementation of improvements in the scenario of cardiac surgeries in the São Paulo State. Although the results in cardiac surgery have improved due to the structuring and organization of quality programs, this is still not a reality in the national scenario. In a situation in which data collection and quality initiatives play a central role for continuous improvement, the complement of value generation becomes fundamental for the sustainability of cardiac surgery programs, in this sense, the concept of Enhanced Recovery After Surgery (ERAS), has gained more and more strength. The concept is based on multidisciplinary protocols and scientific evidence, which help prepare patients for a quick recovery, resulting in a reduction in complications, length of stay and, especially, hospital costs. On the other hand, the SARS-CoV-2 pandemic, which led to the suspension of elective surgeries and an increase in surgical queues, also brought an increase in mortality at home from cardiac causes. Thus, among the various challenges that the current scenario has imposed, we believe that preparing patients for a quick recovery after coronary artery bypass graft surgery becomes a unique opportunity for the safe, effective and sustainable resumption of elective surgeries in the São Paulo State. Thus, the purpose of this project is to evaluate the impact of the rapid recovery flow in the unified health system in the São Paulo State, as well as the effect of the use of the line of care associated with the use of a mobile application, on the patients' postoperative time undergoing coronary artery bypass graft surgery in referral centers in the São Paulo State, compared with conventional perioperative care. (AU)