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TRACE (Routine posTsuRgical Anesthesia visit to improve patient outComE): a prospective, multicenter, stepped-wedge,
Valérie M Smit-Fun1, Dianne de Korte-de Boer2, Linda M Posthuma3
1Department of Anaesthesiology & Pain Medicine, Maastricht University Medical Centre +, P. Debeyelaan 25, 6229 HX, Maastricht, The Netherlands.
Trials
|October 28, 2018
Summary
Routine postoperative anesthesia visits may reduce surgical complications and mortality. This study investigates their impact on patient outcomes and cost-effectiveness in high-risk surgical patients.
Area of Science:
- Anesthesiology
- Surgical Outcomes
- Health Services Research
Background:
- Perioperative complications affect 30-40% of non-cardiac surgical patients, leading to significant morbidity and mortality.
- Early detection and treatment via regular health professional visits may reduce these adverse events.
- The impact of routine postsurgical anesthesia visits on complication rates remains unstudied.
Purpose of the Study:
- To evaluate the effect of routine postoperative visits by anesthesia professionals on 30-day mortality.
- To assess the incidence of postoperative complications and quality of life.
- To determine the cost-effectiveness of this intervention.
Main Methods:
- Prospective, multicenter, stepped-wedge cluster randomized trial (TRACE study) in the Netherlands.
- Inclusion of 5600 high-risk adult surgical patients.
- Comparison of standard care (control) versus routine anesthesia follow-up on postoperative days 1 and 3 (intervention).
Main Results:
- Primary outcome: 30-day postoperative mortality.
- Secondary outcomes: Postoperative complication incidence and quality of life up to one year.
- Statistical analysis using multilevel regression models to compare cohorts.
Conclusions:
- TRACE is the first study to examine routine postoperative anesthesia visits' effect on mortality and cost-effectiveness.
- A positive outcome could lead to direct implementation in participating hospitals due to the study design.
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