Analysis of 24-hour surgical cancellations in an academic rhinology and skull base surgery practice.

Abstract

Late cancellations within 24 hours of surgery lead to decreased utilization of operating room time with loss of productivity, decreased access to care, and inconvenience to patients and staff. To date, no studies have analyzed 24-hour cancellations in a tertiary rhinology practice. All procedures performed at a tertiary rhinology/skull base practice from January 2016 to December 2017 were reviewed. Twenty-four-hour cancellations were analyzed by procedure type and reason for cancellation. Avoidable cancellations were late cancellations that could have been prevented by review of medical records or communication by hospital staff with the patient before surgery. Univariate analysis was performed to determine predictive factors for cancellations. A total of 39 of 640 surgical cases were cancelled (6.1%) within 24 hours of surgery. Of these, 69.2% were inflammatory and 30.8% were skull base cases. The mean number of operating room minutes lost was 151 (60 of 210) for inflammatory and 263 (102 of 480) for skull base cases. Avoidable cancellations were seen in 25 of 35 (71.4%) cases. Patients undergoing inpatient or skull base surgery were more likely to have medical cancellations than patients undergoing outpatient or inflammatory surgery (91.7% vs 43.5%, p = 0.01; 83.3% vs 47.8%, p = 0.07). This is the first study to analyze 24-hour cancellations in tertiary rhinology/skull base surgery. The results suggest that a majority of late cancellations are avoidable and that skull base and inpatient surgeries are more likely to be canceled for medical reasons. Further studies are required to better characterize surgical cancellations in rhinology and identify strategies to try to prevent them.