Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2025 Mar 4;112(3):znaf019.
doi: 10.1093/bjs/znaf019.

Routine anaesthesia ward-based patient visits in surgery: 1-year outcomes of the TRACE randomized clinical trial

Valérie M Smit-Fun  1 , Dianne de Korte-de Boer  1 , Thomas Damen  1 , Annick Stolze  2 , Linda M Posthuma  3 , Markus W Hollmann  2 , Wolfgang F F A Buhre  4 ; TRACE Study Investigators Group
Collaborators, Affiliations
Randomized Controlled Trial

Routine anaesthesia ward-based patient visits in surgery: 1-year outcomes of the TRACE randomized clinical trial

Valérie M Smit-Fun et al. Br J Surg. .

Abstract

Background: The TRACE (Routine posTsuRgical Anaesthesia visit to improve patient outComE) RCT did not show any perioperative benefit from ward-based visits by anaesthetists after surgery. The aim of this study was to evaluate the impact of this intervention on longer-term outcomes.

Methods: Patients were followed up in the TRACE RCT to 1 year in nine hospitals in the Netherlands. Patients undergoing elective non-cardiac surgery, and at risk for adverse postoperative outcome, were included. Patients in the intervention group additionally received routine anaesthesia visits on postoperative days 1 and 3. Clinical outcome measures included 1-year mortality, hospital readmission, and reoperation. Functional recovery (FR) was measured using the patient-reported global surgical recovery (GSR) index, ability to perform activities of daily living (ADL), and functional recovery index (FRI). Quality of life (QoL) was measured using EQ-5D-5L.

Results: Some 5473 adult patients were followed up. No differences were found between the control and intervention groups for clinical, FR, and QoL outcome measures. One-year mortality was 5.4% in the control group and 5.8% in the intervention group, readmission was 27% and 26% respectively, and reoperation was 20% and 18% respectively. At 1 year, FR and QoL had recovered to preoperative levels. However, 30% of patients were not able to fully perform ADL and 40%-51% of patients still reported a problem in the EQ-5D-5L dimensions mobility, usual activities, and pain/discomfort.

Conclusion: Routine postoperative anaesthesia ward visits of patients did not improve clinical, functional, and QoL outcomes. A substantial proportion of patients still experienced health-related limitations in daily life 1 year after surgery. In conclusion, an early postoperative intervention with postoperative anaesthesia visits in the ward after non-cardiac surgery had no effect on 30-day or 1-year clinical outcome. Remarkably, TRACE shows that compared with data sampled 10 years ago, 1-year mortality has not improved in the Netherlands. At 1 year, functional recovery or QoL showed little improvement compared with baseline. Importantly, a substantial number of patients still reported incomplete recovery and problems that limit QoL, which indicate that there is still room for improvement.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Patient flow diagram
Fig. 2
Fig. 2
EQ-5D-5L VAS and EQ-5D-5L index for the control and intervention groups VAS, visual analogue scale.
Fig. 3
Fig. 3
Percentage of patients reporting a problem within EQ-5D-5L dimensions from baseline up to 1 year after surgery Reporting a problem was defined as an EQ-5D-5L dimension response of ≥2.
See this image and copyright information in PMC

References

    1. Fried TR, Bradley EH, Towle VR, Allore H. Understanding the treatment preferences of seriously ill patients. N Engl J Med 2002;346:1061–1066 - PubMed
    1. Wrenn SM, Cepeda-Benito A, Ramos-Valadez DI, Cataldo PA. Patient perceptions and quality of life after colon and rectal surgery: what do patients really want? Dis Colon Rectum 2018;61:971–978 - PubMed
    1. Sikder T, Sourial N, Maimon G, Tahiri M, Teasdale D, Bergman H et al. Postoperative recovery in frail, pre-frail, and non-frail elderly patients following abdominal surgery. World J Surg 2019;43:415–424 - PubMed
    1. Smit-Fun VM, De Korte-De Boer D, Posthuma LM, Stolze A, Dirksen CD, Hollmann MW et al. TRACE (Routine posTsuRgical Anesthesia visit to improve patient outComE): a prospective, multicenter, stepped-wedge, cluster-randomized interventional study. Trials 2018;19:586. - PMC - PubMed
    1. Buhre WFFA, De Korte-De Boer D, Boer C et al. Routine postsurgical anesthesia visit to improve 30-day morbidity and mortality: a multicenter, stepped-wedge cluster randomized interventional study (the TRACE study). Ann Surg 2023;277:375–380 - PMC - PubMed

Publication types