Cancellation of elective operations on the day of intended surgery in a Hong Kong hospital: point prevalence and reasons

Abstract

OBJECTIVE. To determine the point prevalence of elective surgical case cancellations and the reasons.

DESIGN. Cross-sectional study.

SETTING. Teaching hospital, Hong Kong.

PATIENTS. Operating theatre records of elective surgery cancellations from 1 January 2009 to 31 December 2009 were retrospectively reviewed.

MAIN OUTCOME MEASURES. Cancellation of scheduled elective surgery on the day of surgery and the corresponding reasons.

RESULTS. Of 6234 cases scheduled, 476 were cancelled, which yielded a point prevalence of 7.6%, with a 95% confidence interval of 7.0-8.3%. The highest number of cancellations occurred in patients scheduled for major general surgical procedures (n=94, 20%), major urological procedures (n=64, 13%), major orthopaedic surgery (n=38, 8%), and ultra-major cardiothoracic surgery (n=29, 6%). The most common category for cancellation was facility (73%), followed by work-up (17%), patient (10%), and surgeon (1%). No available operating room time due to overrun of the previous surgery was the most common reason for case cancellation (n=310). Compared to general surgery, the odds of no available operating time was significantly less in orthopaedics (odds ratio=0.26; 95% confidence interval, 0.17-0.39), otolaryngology (0.25; 0.13-0.46), neurosurgery (0.36; 0.16-0.70), paediatrics (0.53; 0.31-0.87), gynaecology (0.18; 0.11-0.29), ophthalmology (0.19; 0.07-0.41), and dentistry (0.10; 0.00-0.60).

CONCLUSIONS. Case cancellations were mainly due to facility factors, such as no operating room time being available. The odds of having no operating room time available varied between surgical specialties.