Cancellations of elective surgical procedures performed at a Teaching Hospital in North-West Nigeria

Abstract

Background: Cancellation of cases on the scheduled day of surgery leads to inefficient utilization of operating theater space, waste of valuable workforce, and scarce resources for patients and hospitals. Objectives: The objective of this study is to determine the prevalence and reasons for cancellations of elective surgical procedures done at Aminu Kano Teaching Hospital, Kano. Materials and Methods: A retrospective cross-sectional descriptive study was undertaken by reviewing the list of all patients whose names appeared on the routine elective surgical operation lists in the Surgical Departments of the hospital, from January to September 2012. The list of those whose surgeries were cancelled was compiled. A sample of 200 cases (determined using appropriate formula, n = z 2 pq/d 2 ) were selected by stratified sampling technique with proportionate allocation. The demographic data, diagnosis, specialty of surgery, proposed surgery, and reasons for cancellation were extracted and analyzed. Results: A total of 2355 cases were booked for elective surgeries during the study. Out the 200 sample selected for the study, 97 were cancelled for various reasons giving a cancellation rate of 48.5%. Overall, Obstetrics and Gynecology accounted for the highest number of cases booked 27.5% (55 out of 200) and cancelled 27.8% (27 out of 97); and had the highest cancellation rate of 49.1% (27 out of 55). The most common reason for the cancellation was a patient factor (60.8%) arising from patient absconding from surgery for personal reasons not communicated to the surgeons, and lack of funds to pay for surgery. Conclusion: The prevalence of cancellation of elective cases on the scheduled day of surgery is still high in our hospital. Most of the causes of the cancellations are due to patient-related factors which are preventable and avoidable. Avoidance of unnecessary cancellations of cases is an important way of ensuring efficient utilization of scarce resources. Adequate counseling before, during, and after elective surgical procedures in our setting is highly recommended.