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Multicenter Study
. 2022 Feb;46(2):382-390.
doi: 10.1007/s00268-021-06364-1. Epub 2021 Nov 16.

Assessing the Rates and Reasons of Elective Surgical Cancellations on the Day of Surgery: A Multicentre Study from Urban Indian Hospitals

Bhakti Sarang  1   2 , Geetu Bhandoria  3 , Priti Patil  1   4 , Anita Gadgil  1   5 , Lovenish Bains  1   6 , Monty Khajanchi  1   7 , Deepa Kizhakke Veetil  8 , Rohini Dutta  1   9 , Priyansh Shah  10 , Prashant Bhandarkar  1   11 , Lileswar Kaman  12 , Dhruva Ghosh  13   14 , Kavita Mandrelle  15 , Ashwani Kumar  16 , Akshay Bahadur  17 , Sunil Krishna  18 , Kamal Kishore Gautam  19 , Ya Dev  20 , Manisha Aggarwal  16 , Neil Thivalapill  21 , Nobhojit Roy  22   23 ; IndSurg Collaboration
Collaborators, Affiliations
Multicenter Study

Assessing the Rates and Reasons of Elective Surgical Cancellations on the Day of Surgery: A Multicentre Study from Urban Indian Hospitals

Bhakti Sarang et al. World J Surg. 2022 Feb.

Abstract

Background: Cancellations of elective surgeries on the day of surgery (DOS) can lead to added financial burden and wastage of resources for healthcare facilities; as well as social and emotional problems to patients. These cancellations act as barriers to delivering efficient surgical services. Optimal utilisation of the available resources is necessary for resource-constrained low-and-middle-income countries (LMIC). This study investigates the rate and causes of cancellations of elective surgeries on the DOS in various surgical departments across ten hospitals in India.

Methods: A research consortium 'IndSurg' led by World Health Organisation Collaboration Centre (WHOCC) for Research in Surgical Care Delivery in LMICs, India conducted this multicentre retrospective cross-sectional study to analyse the cancellations of elective/planned surgical operations on DOS across urban secondary and tertiary level hospitals. We audited surgical records of a pre-decided period of six weeks for cancellations, documented relevant demographic information and reasons for cancellations.

Results: We analysed records from the participating hospitals, with an overall cancellation rate of 9.7% (508/5231) on the DOS for elective surgical operations. Of these, 74% were avoidable cancellations. A majority (30%) of these 508 cancellations were attributed to insufficient resources, 28% due to patient's refusal or failure to show-up, and 22% due to change in patient's medical status.

Conclusion: We saw a preponderance of avoidable reasons for elective surgery cancellations. A multidisciplinary approach with adequate preoperative patient counselling, timely communication between the patients and caregivers, adequate preoperative anaesthetic assessment, and planning by the surgical team may help reduce the cancellation rate.

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Conflict of interest statement

None.

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Fig. 1
Recruitment algorithm and hospital characteristics
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