BACKGROUND: After major abdominal surgery (MAS), 20  % of @entity1 endure major complications, which require invasive treatment and are associated with increased morbidity and mortality. A quality control algorithm after major abdominal surgery aimed at early identification of @entity1 at risk of developing major complications can decrease associated morbidity and mortality. Literature studies show promising results for @entity1851 ( @entity1851 ) as an early marker for @entity260 , however clinical significance has yet to be determined. METHODS: A multicenter, stepped wedge, prospective clinical trial including all adult @entity1 planned to undergo elective MAS. The first period consists of standard postoperative monitoring, which entails on demand additional examinations. This is followed by a period with implementation of postoperative control according to the PRECious protocol, which implicates standardized measurement of @entity1851 levels. If @entity1851 levels exceed 140  mg/L on postoperative day 3,4 or 5, an enhanced CT-scan is performed. Primary outcome in this study is a combined primary outcome, entailing all morbidity and mortality due to @entity260 . Complications are graded according to the Clavien-Dindo classification. Secondary outcomes are hospital length of stay, @entity1 reported outcome measures (PROMs) and cost-effectiveness. Data will be collected during admission, three months and one year postoperatively. Approval by the medical ethics committee of the VU University Medical Center was obtained (ID 2015.114). DISCUSSION: the PRECious trial is a stepped-wedge, multicenter, open label, prospective clinical trial to determine the effect of a standardized postoperative quality control algorithm on postoperative morbidity and mortality, and cost-effectiveness. TRIAL REGISTRATION: www.ClinicalTrials.gov, NCT02102217 . Registered 5 February 2015.

The PRECious trial PREdiction of Complications, a step-up approach, XXXX first followed by CT-scan imaging to ensure quality control after major abdominal surgery: study protocol for a stepped-wedge trial.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity260 :: ('MESH:D011183', 'Disease') :: ['postoperative complications'] @entity1851 :: ('1401', 'Gene') :: ['CRP', 'C-reactive protein']
@entity1851 :: (1401,Gene) :: ['CRP']
