Global prevalence and reasons for case cancellation on the intended day of surgery: A systematic review and meta-analysis

Abstract

Background: Cancellation of operation on the intended day of surgery affects the efficiency of Operation Room which incurs a significant financial loss for the patient, hospital, and health care cost of a country at large. This systematic and Meta-Analysis was intended to provide evidence on the global prevalence and determinants of case cancellation on the intended day of surgery.

Methods: A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from January 2010 to May 2020 without language restriction. The Heterogeneity among the included studies was checked with forest plot, χ2 test, I2 test, and the p-values. All observational studies reporting prevalence and determinants were included.

Results: A total of 1207 articles were identified from different databases with an initial search. Fort-eight articles were selected for evaluation after the successive screening. Thirty-three Articles with 306,635 participants were included. The Meta-Analysis revealed that the global prevalence of case cancellation on the intended day of surgery was 18% (95% CI: 16 to 20). The Meta-Analysis also showed that lack of operation theatre facility accounted for the major reason for cancellation followed by no attendant and change in medical condition.

Conclusion: The meta-analysis revealed that the prevalence of case cancellation was very high in low and middle-income countries and the majorities were avoidable which entails rigorous activities on operation theatre facilities, preoperative evaluation and preparation, patient and health care provider communications.

Registration: This Systematic Review and Meta-Analysis was registered in a research registry (researchregistry5746) available at https://www.researchregistry.com/browse-the-registry#home/.

Keywords: Cancellation; Determinants; Global; Prevalence; Surgery.

Fig. 1

Prisma flow chart.

Fig. 2

Forest plot for the global prevalence of cancellation on the intended day of surgery by income level of countries: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.

Fig. 3

Forest plot for subgroup analysis prevalence of cancellation on the intended day of surgery by income level of countries: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.

Fig. 4

Forest plot for subgroup analysis prevalence of cancellation on the intended day of surgery by income level of countries: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.

Fig. 5

Forest plot for subgroup analysis prevalence of cancellation on the intended day of surgery by income level of countries: The midpoint of each line illustrates the prevalence; the horizontal line indicates the confidence interval, and the diamond shows the pooled prevalence.

Fig. 6

Funnel and Trim Fill funnel plot showing publication bias. The vertical line indicates the effect size while the diagonal line indicates the precision of individual studies with a 95% confidence interval.