The 30-day outcome findings in patients undergoing postponed elective surgery during the COVID-19 pandemic (TRACE II) were presented at a poster session at Euroanaesthesia 2023.
The COVID-19 pandemic significantly affected the ability to perform elective surgeries worldwide. To understand the consequences of delayed surgery, the TRACE II study investigates the impact on patients' preoperative health condition, complications after surgery, and their quality of life (QoL) in cases where elective surgeries were postponed.
The study was conducted from September 2020 onward in seven Dutch hospitals. It was an observational, multicentre, prospective cohort study that compared its results with the control group of the original Routine Postsurgical Anesthesia Visit to Improve Patient Outcome (TRACE I) study. The primary outcome, the incidence of major complications within 30 days, was compared between the two cohorts.
The TRACE II study included 1479 patients and compared them to 2490 control patients from TRACE. At the beginning of the study, more patients in TRACE II had a higher ASA score (a measure of physical health) and a lower METS score (a measure of exercise capacity) than the control group. The baseline quality of life was also lower in TRACE II, as was the severity grade of surgeries.
The delay in surgery ranged from 1 day to 744 days. Within 30 days after surgery, 58 patients (2.3%) in the control group (TRACE) experienced major complications, while 54 patients (3.7%) in the TRACE II group had major complications. The adjusted odds ratio for major complications in TRACE II compared to TRACE was 1.29, indicating a slightly higher risk in TRACE II, but this difference was not statistically significant. The difference in quality of life at 30 days between the two cohorts was statistically significant, indicating a slightly lower quality of life in TRACE II compared to TRACE.
Overall, 30-day outcome findings from TRACE II indicate that patients who underwent delayed elective surgery had more serious comorbidities. However, there was no significant increase in major postoperative complications compared to the control cohort from the TRACE study. The quality of life for patients undergoing delayed elective surgery appeared to be lower both before and after the surgical procedure.
Source: Euroanaesthesia 2023
Image Credit: ESAIC