Why the study?
Unexpected preoperative surgery cancellations are a significant problem in daily anesthesia practice, particularly when they occur in the operating room, prompting evaluation of their prevalence and causes.
Elective surgery cancellations in the operating room occur at a rate of 0.9%, with older age and higher ASA physical status being significant risk factors, and nearly 60% of these cancellations are potentially avoidable.
Cancellations after OR arrival disproportionately affect older, higher-ASA patients; leaves open whether targeted preoperative optimization reduces rates.
Unexpected preoperative surgery cancellations are one of the important problems in daily anesthesia practice. It's an even bigger problem if these cancellations happen in the operating room. Our aim was to draw attention to this issue and reveal the reasons. This prospective, cross-sectional study aimed to assess the prevalence and causes of elective surgery cancellations once patients are in the operating room. The study sample consisted of 7482 adult patients scheduled for elective surgeries and taken to the operating room. Sixty-seven patients whose surgeries were canceled were grouped into Group 1, while the remaining 7415 whose surgeries were completed were in Group 2. Patients were divided into two groups based on whether their surgeries were completed or canceled. Factors such as age, American Society of Anesthesiologists physical status, and surgical department were analyzed. Metrics involved comparisons between the two groups regarding age, American Society of Anesthesiologists physical status classification, surgical department, and timing of the surgery. The prevalence of elective surgery cancellations after patients were in the operating room was 0.9%. Group 1 was significantly older than Group 2 (p<0.001). The proportion of patients classified as American Society of Anesthesiologists physical status III was higher in Group 1 (p<0.001). The department with the highest cancellation rate was ophthalmology(2.5%), followed by general surgery(2.1%), urology(1.5%), and ear, nose, and throat(1.4%). Approximately 59.7% of cancellations were deemed potentially avoidable. The study suggests that many of these cancellations are potentially avoidable, underscoring the need for optimized surgical scheduling and patient assessment protocols.
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Özcan et al. (2023) studied this question.
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