Exploring the rate and reasons for same-day cancellation of cardiac surgery after implementing joint commission international standards: a retrospective cross-sectional study

Abstract

BackgroundSame-day cancellation of cardiac surgery significantly impacts operating room management efficiency, which can be mitigated by taking preventive measures. This study aimed to explore the same-day cancellation rate of elective adult cardiac surgery, as well as the reasons for those cancellations. A retrospective cross-sectional study reviewed the records of 581 scheduled elective adult cardiac surgical cases at a single cardiac center from June 2017 to May 2018. The same-day cancellation reasons were grouped into four broad categories: nonclinical cancellations, clinical cancellations, patient-related cancellations, and 'other reason' cancellations. A case was considered canceled when it was not performed on the same day as the planned surgery.ResultsA total of 581 elective adult cardiac surgeries were scheduled during the study period, and 56 (9.63%) of these were canceled. The highest cancellation rate was due to nonclinical cancellations, with 39% of scheduled cases, followed by clinical cancellations, with a 34% cancellation rate. Patient-related cancellations accounted for 23% of cancellations, while the lowest rate was due to ‘other reasons,’ which accounted for 4% of total cancellations. The most common reason for nonclinical cancellations was the inclusion of emergency cases (n = 8; 14%). The most common reason for clinical cancellations was changes in the patient’s medical condition (n = 8, 14%). The common reason for patient-related cancellations was the refusal of surgery (n = 9; 16%). The lowest rate was for menstruating female patients (n = 2; 4%).ConclusionsThe same-day cancellation rate was 9.36%, and most of the cancellation reasons could be mitigated by implementing preventive strategies to improve the efficiency of the operating room. Preoperative preparation clinics and paying particular attention to female patients scheduled for surgery might reduce the rate of elective cardiac surgery cancellation.