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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals
British Journal of Anaesthesia, Volume 121, No. 4, Year 2018
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Description
Background: Cancellation of planned surgery impacts substantially on patients and health systems. This study describes the incidence and reasons for cancellation of inpatient surgery in the UK NHS. Methods: We conducted a prospective observational cohort study over 7 consecutive days in March 2017 in 245 NHS hospitals. Occurrences and reasons for previous surgical cancellations were recorded. Using multilevel logistic regression, we identified patient- and hospital-level factors associated with cancellation due to inadequate bed capacity. Results: We analysed data from 14 936 patients undergoing planned surgery. A total of 1499 patients (10.0%) reported previous cancellation for the same procedure; contemporaneous hospital census data indicated that 13.9% patients attending inpatient operations were cancelled on the day of surgery. Non-clinical reasons, predominantly inadequate bed capacity, accounted for a large proportion of previous cancellations. Independent risk factors for cancellation due to inadequate bed capacity included requirement for postoperative critical care [odds ratio (OR)=2.92; 95% confidence interval (CI), 2.12–4.02; P<0.001] and the presence of an emergency department in the treating hospital (OR=4.18; 95% CI, 2.22–7.89; P<0.001). Patients undergoing cancer surgery (OR=0.32; 95% CI, 0.22–0.46; P<0.001), obstetric procedures (OR=0.17; 95% CI, 0.08–0.32; P<0.001), and expedited surgery (OR=0.39; 95% CI, 0.27–0.56; P<0.001) were less likely to be cancelled. Conclusions: A significant proportion of patients presenting for surgery have experienced a previous cancellation for the same procedure. Cancer surgery is relatively protected, but bed capacity, including postoperative critical care requirements, are significant risk factors for previous cancellations. © 2018 British Journal of Anaesthesia
Authors & Co-Authors
Wong, Danny Jon Nian
United Kingdom, London
Royal College of Anaesthetists
United Kingdom, London
University College London Hospitals Nhs Foundation Trust
Moonesinghe, Suneetha Ramani
United Kingdom, London
Royal College of Anaesthetists
United Kingdom, London
University College London Hospitals Nhs Foundation Trust
Drake, Sharon
Unknown Affiliation
Wagstaff, Duncan T.
Unknown Affiliation
Grocott, Michael P.W.
Unknown Affiliation
Sneyd, J. Robert
Unknown Affiliation
Brett, Stephen J.
Unknown Affiliation
Tyrrell, Samuel
Unknown Affiliation
Paley, Carole S.
Unknown Affiliation
Scriven, John
Unknown Affiliation
Raj, Ashok Sundai
Unknown Affiliation
Abbott, Tom Ef
Unknown Affiliation
Sellers, Daniel
Unknown Affiliation
Cupitt, Jason M.
Unknown Affiliation
Balasubramaniam, Madhu Shankar
Unknown Affiliation
Spencer, Robert F.
Unknown Affiliation
White, Stuart M.
Unknown Affiliation
Hill, Stephen A.
Unknown Affiliation
Anantharaman, Venkataraman
Unknown Affiliation
Bhatia, Sanchita
Unknown Affiliation
Mostafa, Tarek Ahmed
Unknown Affiliation
Adamson, Christine C.D.
Unknown Affiliation
Santhirapala, Vatshalan
Unknown Affiliation
Spittle, Nick
Unknown Affiliation
Church, Helen Rachael
Unknown Affiliation
Wilson, Lawrence Anthony
Unknown Affiliation
Faulkner, Maria
Unknown Affiliation
Wakefield, Phillipa
Unknown Affiliation
Mohamed, Mona Ali
Unknown Affiliation
Dobson, Richard J.B.
Unknown Affiliation
Williams, Tricia J.
Unknown Affiliation
Hills, Vicky M.
Unknown Affiliation
Kapoor, Ritoo
Unknown Affiliation
Feneley, Andrew
Unknown Affiliation
Hammad, Walid
Unknown Affiliation
Daniels, Alex
Unknown Affiliation
Rosedale, Katherine J.
Unknown Affiliation
El-Boghdadly, Kariem
Unknown Affiliation
Adelaja, Yemi A.
Unknown Affiliation
Mupudzi, McDonald
Unknown Affiliation
Yeung, Joyce H.Y.
Unknown Affiliation
Casely, Emma M.
Unknown Affiliation
Kam, Elisa P.Y.
Unknown Affiliation
Smith, Neil C.E.
Unknown Affiliation
Foly, Ahmed Gamaleldin
Unknown Affiliation
Hassanin, A. I.
Unknown Affiliation
Mensah, Kofi Tawiah
Unknown Affiliation
Statistics
Citations: 72
Authors: 47
Affiliations: 3
Identifiers
Doi:
10.1016/j.bja.2018.07.002
ISSN:
00070912
Research Areas
Cancer
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study
Case-Control Study
Study Approach
Quantitative