Retrospective analysis of suspended surgeries and influencing factors during an 8-year period

Abstract

Introduction: The main objective was the description and analysis of suspended surgeries and their causes for suspension at our hospital from the year 2010 to the present. As a secondary objective, we evaluated the effectiveness of a series of measures for improvement.

Methods: A retrospective study was conducted to analyze patients who were scheduled to undergo surgery that was finally suspended. A Failure Mode and Effects Analysis (FMEA) was carried out to analyze the causes of the suspensions and their consequences, any existing barriers and possible measures that have been implemented over time. The causes were classified as attributable to the patient, administrative causes and medical causes.

Results: 105,403 surgeries were scheduled, 3,867 of which were suspended (3.66%). Factors that influenced the suspensions included: surgical specialty, ASA 4 patients, elderly patients, ambulatory patients and surgeries scheduled during the winter. The most frequent medical cause was infection or fever (17.6%), while the most frequent administrative and patient causes were lack of time (26.8%) and no-show (6.3%), respectively. The avoidable causes were 64.8% versus 35.2% unavoidable causes. In the multivariate analysis, risk factors included age, shift, season and surgical service.

Conclusions: Surgical cancellations have repercussions on the consumption of material and human resources. Any means to reduce their incidence should be our future priority in order improve the quality of care.

Keywords: Calidad; Cancelaciones quirúrgicas; Cirugía; Quality; Surgery; Surgical cancellations; Suspended surgeries; Suspensiones quirúrgicas.