Medical reasons that cause the postponement of scheduled pediatric cardiovascular surgeries in a tertiary center in Turkey: what should be the limit of postponement?

Background Preoperative evaluation and elimination of the identified medical problems is one of the most important steps of surgeries to reduce perioperative morbidity and mortali- ty risks. The aim of this study is to present the medical reasons which resulted in the postponement of scheduled pedia- tric cardiovascular surgeries in our center and to discuss what should be the limit of surgical postponement rates. Patients and methods This retrospective study included 123 pediatric patients whose scheduled cardiovascular operations were post- poned in Kartal Koşuyolu Research and Training Hospi- tal from April, 2014 to May, 2015. The postponement rates due to medical reasons were calculated and corre- lations between the age and gender of children, type of surgery and postponement were analyzed statistically. Results Out of 380 scheduled children, 0 to 16 years old (mean age 4.2±5.1 years), 123 were postponed 1 to 7 days (mean 3.8±2.4 days) before the planned date of opera- tion. The postponement rate was 32.3%. Medical rea- sons for the postponement were lower (53.7%) or upper respiratory tract (15.4%) infections, neurologic (8.2%), urinary tract (6.5%) or gastroenterologic diseases (5.7%), endocrinologic (5.7%) or hematologic (3.2%) abnormalities and varicella infection (2.6%). Postpone- ment was found to have a significant relationship with the age (p<0.05), but not with the gender of the children or type of the scheduled operation (p>0.05). Conclusion As a tertiary center that accepts children from va- rious regions of the country, we should develop some strategies to decrease the postponement rates for ratio- nal use of the operating theaters without neglecting the preoperative evaluation for surgical safety.