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Article: Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals

TitleCancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals
Authors
Wong, D. J.N.Harris, S. K.Moonesinghe, S. R.Moonesinghe, S. RamaniWong, Danny J.N.Harris, Steve K.Bedford, JamesBoney, OliverChazapis, MariaDrake, SharonFarmer, LauraGovindaraju, RamanaCarl, IlyasGilhooly, DavidGoodwin, JamesLourtie, JoseWagstaff, DuncanGrocott, MikeSneyd, RobertBatchelor, AnnaBrett, StephenPlowright, CatherineShrestha, SumanShawyer, RichardAhmed, ShafiKhondoker, MizanNathanson, MikeCripps, PaulResearch & Audit Federation of Trainees (RAFT)Anaesthetic AuditIntensive Care & Anaesthesia Research Network of North East Trainees (INCARNNET)Merseyside Anaesthetic Group for Improving Quality (MAGIQ)Midlands East Research by Critical CareNorth West ResearchOxford Critical Care Anaesthetic Research Enterprise (OxCCARE)Pan-London Peri-operative Audit & Research Network (PLAN)Scottish East Quality Improvement & Research Academy (SEQuoIA)SESSA Quality ImprovementSevern Trainees Anaesthetic Research (STAR)South West Anaesthetic Research Matrix (SWARM)South Yorkshire Hospitals AuditSouthcoast Peri-operative AuditWelsh Anaesthetic Audit Research & Engagement Network (WAAREN)West Midlands Trainee Research Anaesthesia & Intensive Care Network (WMTRAIN)Rawat, ShilpaSathe, SoniaCampbell, AlisonAnandarajah, JanakanBall, NicolaBandara, LalindraBarnes, DennisChapman, CatherineConnor, LyndaCook, AmandaEbejer, AmandaEvans, SamanthaGallagher, MaireGoff, SarahHalfacree, IrinaHarford, RachelHarris, CatherineJackson, RebeccaJames, KathrynJones, ClaireJones, SharonMalinovszky, KathyMungai, SerahNageswaran, HariPerumal, AnandPudge, HarrietQuinn, LeanneSheppard, ThomasSmith, TrudySpargo, JamesStorton, SharonThomas, CaradogThomas, CharlotteTyrrell, SamuelVale, OwenWilliams, CatrinWilliams, MarieWilliams, TomWinfield-Young, LewysWorrell, HelenMoloney, DermotChuni, ChandiniComara, JasnaConway, BrianEagle, ZaraFoster, GregPlatt, ChrisThorne, AlisonHee, Wendy LumArmstrong, LisaBrennan, AlbertBurns, JustineBusby, ChantalCouch-Upite, MecheleDooks, EmmaDunlop, SallyEijk, Anya
KeywordsHealth Services Research
surgery
operating room management
medical resource utilisation
Issue Date2018
Citation
British Journal of Anaesthesia, 2018, v. 121, n. 4, p. 730-738 How to Cite?
Abstract© 2018 British Journal of Anaesthesia 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.
Persistent Identifierhttp://hdl.handle.net/10722/279358
ISSN
2023 Impact Factor: 9.1
2023 SCImago Journal Rankings: 2.397
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, D. J.N.-
dc.contributor.authorHarris, S. K.-
dc.contributor.authorMoonesinghe, S. R.-
dc.contributor.authorMoonesinghe, S. Ramani-
dc.contributor.authorWong, Danny J.N.-
dc.contributor.authorHarris, Steve K.-
dc.contributor.authorBedford, James-
dc.contributor.authorBoney, Oliver-
dc.contributor.authorChazapis, Maria-
dc.contributor.authorDrake, Sharon-
dc.contributor.authorFarmer, Laura-
dc.contributor.authorGovindaraju, Ramana-
dc.contributor.authorCarl, Ilyas-
dc.contributor.authorGilhooly, David-
dc.contributor.authorGoodwin, James-
dc.contributor.authorLourtie, Jose-
dc.contributor.authorWagstaff, Duncan-
dc.contributor.authorGrocott, Mike-
dc.contributor.authorSneyd, Robert-
dc.contributor.authorBatchelor, Anna-
dc.contributor.authorBrett, Stephen-
dc.contributor.authorPlowright, Catherine-
dc.contributor.authorShrestha, Suman-
dc.contributor.authorShawyer, Richard-
dc.contributor.authorAhmed, Shafi-
dc.contributor.authorKhondoker, Mizan-
dc.contributor.authorNathanson, Mike-
dc.contributor.authorCripps, Paul-
dc.contributor.authorResearch & Audit Federation of Trainees (RAFT)-
dc.contributor.authorAnaesthetic Audit-
dc.contributor.authorIntensive Care & Anaesthesia Research Network of North East Trainees (INCARNNET)-
dc.contributor.authorMerseyside Anaesthetic Group for Improving Quality (MAGIQ)-
dc.contributor.authorMidlands East Research by Critical Care-
dc.contributor.authorNorth West Research-
dc.contributor.authorOxford Critical Care Anaesthetic Research Enterprise (OxCCARE)-
dc.contributor.authorPan-London Peri-operative Audit & Research Network (PLAN)-
dc.contributor.authorScottish East Quality Improvement & Research Academy (SEQuoIA)-
dc.contributor.authorSESSA Quality Improvement-
dc.contributor.authorSevern Trainees Anaesthetic Research (STAR)-
dc.contributor.authorSouth West Anaesthetic Research Matrix (SWARM)-
dc.contributor.authorSouth Yorkshire Hospitals Audit-
dc.contributor.authorSouthcoast Peri-operative Audit-
dc.contributor.authorWelsh Anaesthetic Audit Research & Engagement Network (WAAREN)-
dc.contributor.authorWest Midlands Trainee Research Anaesthesia & Intensive Care Network (WMTRAIN)-
dc.contributor.authorRawat, Shilpa-
dc.contributor.authorSathe, Sonia-
dc.contributor.authorCampbell, Alison-
dc.contributor.authorAnandarajah, Janakan-
dc.contributor.authorBall, Nicola-
dc.contributor.authorBandara, Lalindra-
dc.contributor.authorBarnes, Dennis-
dc.contributor.authorChapman, Catherine-
dc.contributor.authorConnor, Lynda-
dc.contributor.authorCook, Amanda-
dc.contributor.authorEbejer, Amanda-
dc.contributor.authorEvans, Samantha-
dc.contributor.authorGallagher, Maire-
dc.contributor.authorGoff, Sarah-
dc.contributor.authorHalfacree, Irina-
dc.contributor.authorHarford, Rachel-
dc.contributor.authorHarris, Catherine-
dc.contributor.authorJackson, Rebecca-
dc.contributor.authorJames, Kathryn-
dc.contributor.authorJones, Claire-
dc.contributor.authorJones, Sharon-
dc.contributor.authorMalinovszky, Kathy-
dc.contributor.authorMungai, Serah-
dc.contributor.authorNageswaran, Hari-
dc.contributor.authorPerumal, Anand-
dc.contributor.authorPudge, Harriet-
dc.contributor.authorQuinn, Leanne-
dc.contributor.authorSheppard, Thomas-
dc.contributor.authorSmith, Trudy-
dc.contributor.authorSpargo, James-
dc.contributor.authorStorton, Sharon-
dc.contributor.authorThomas, Caradog-
dc.contributor.authorThomas, Charlotte-
dc.contributor.authorTyrrell, Samuel-
dc.contributor.authorVale, Owen-
dc.contributor.authorWilliams, Catrin-
dc.contributor.authorWilliams, Marie-
dc.contributor.authorWilliams, Tom-
dc.contributor.authorWinfield-Young, Lewys-
dc.contributor.authorWorrell, Helen-
dc.contributor.authorMoloney, Dermot-
dc.contributor.authorChuni, Chandini-
dc.contributor.authorComara, Jasna-
dc.contributor.authorConway, Brian-
dc.contributor.authorEagle, Zara-
dc.contributor.authorFoster, Greg-
dc.contributor.authorPlatt, Chris-
dc.contributor.authorThorne, Alison-
dc.contributor.authorHee, Wendy Lum-
dc.contributor.authorArmstrong, Lisa-
dc.contributor.authorBrennan, Albert-
dc.contributor.authorBurns, Justine-
dc.contributor.authorBusby, Chantal-
dc.contributor.authorCouch-Upite, Mechele-
dc.contributor.authorDooks, Emma-
dc.contributor.authorDunlop, Sally-
dc.contributor.authorEijk, Anya-
dc.date.accessioned2019-10-28T03:02:27Z-
dc.date.available2019-10-28T03:02:27Z-
dc.date.issued2018-
dc.identifier.citationBritish Journal of Anaesthesia, 2018, v. 121, n. 4, p. 730-738-
dc.identifier.issn0007-0912-
dc.identifier.urihttp://hdl.handle.net/10722/279358-
dc.description.abstract© 2018 British Journal of Anaesthesia 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.-
dc.languageeng-
dc.relation.ispartofBritish Journal of Anaesthesia-
dc.subjectHealth Services Research-
dc.subjectsurgery-
dc.subjectoperating room management-
dc.subjectmedical resource utilisation-
dc.titleCancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.bja.2018.07.002-
dc.identifier.pmid30236235-
dc.identifier.scopuseid_2-s2.0-85054450371-
dc.identifier.volume121-
dc.identifier.issue4-
dc.identifier.spage730-
dc.identifier.epage738-
dc.identifier.eissn1471-6771-
dc.identifier.isiWOS:000447401000009-
dc.identifier.issnl0007-0912-

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