Analysis of the incidence and reasons of the same-day cancellation of non-cataract ophthalmic ambulatory surgery

Abstract

Objective: To investigate the incidence and reasons of the same-day cancellation of non-cataract ophthalmic ambulatory surgery, and to provide a basis for further improvement of the medical quality of ophthalmic ambulatory surgery. Methods: The data of the appointment for ophthalmic ambulatory surgeries from December 1, 2020 to November 30, 2021, including the patient's general condition, disease diagnosis, proposed surgical arrangement, anesthesia method and the completion of the surgeries, were collected through the electronic medical record management system in Beijing Tongren Hospital, Capital Medical University. The total number and incidence of cancelled surgeries registered in the surgical center were analyzed, the incidence of cancelled surgeries of different ages, sexes, subspecialty surgical types, anesthesia methods, patient sources were analyzed, and the reasons for surgical cancellation were further analyzed. Results: A total of 10, 595 non-cataract ophthalmic day surgeries were applied, of which 827 were temporarily cancelled on the day of surgery, with a cancellation rate of 7.8%. The difference in the same-day surgery cancellation rate at different ages was statistically significant (P<0.001), of which the surgery cancellation rate in toddler and infants was the lowest, which was 2.1% (23/1 110) and 3.4% (2/59), respectively, while the surgery cancellation rate was the highest in elderly patients over 75 years old, at 10.4% (48/462). There was a statistically significant difference in surgical cancellation rates among different sub-specialties (P<0.001), with the lowest surgical cancellation rate in the tumor sub-specialty at 4.5% (33/732), while the corneal sub-specialty had the highest surgical cancellation rate at 14.3% (40/280), followed by the plastic sub-specialty with 11.8% (153/1 297). There were no statistically significant differences in the rate of surgical cancellation between different sexes, anesthesia methods or patients' home address (all P>0.05). The most common reason for same-day surgery cancellation was the absence of the patient on the day of surgery (49.7%, 479/827), followed by changes in the patient's general condition (18.4%, 152/827), and inadequate preoperative preparation (6.0%, 50/827). 64.3% (532/827) of the same-day surgical cancellations were considered to have been avoided by enhancing preoperative communication, consultation and management. Conclusions: The same-day cancellation rate of ambulatory surgery in non-cataract ophthalmology is 7.8%, of which the cancellation rate in elderly patients and in less invasive surgery are higher. The absence of the patient on the same day and the change of the patient's condition are the main reasons for the cancellation of surgery on the same day, and most of them are avoidable.