RT Journal Article
SR Electronic
T1 Cancellations and delays of emergent orthopedic operations at a Canadian level 1 trauma centre
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP E382
OP E387
DO 10.1503/cjs.009420
VO 65
IS 3
A1 Denis, Antoine
A1 Montreuil, Julien
A1 Harvey, Edward J.
A1 Berry, Gregory K.
A1 Reindl, Rudolf
A1 Bernstein, Mitchell
YR 2022
UL http://canjsurg.ca/content/65/3/E382.abstract
AB Background: Day-of surgery cancellation (DOSC) is considered to be a very inefficient use of hospital resources and results in emotional stress for the patient. To examine opportunities to minimize the incidence of preventable cancellations — an indicator of quality of care — we assessed the incidence of and reasons for DOSCs over 3 months among inpatients and outpatients at a trauma orthopedic service.Methods: This was a prospective study of 2 cohorts of patients, inpatients and outpatients, scheduled for emergent orthopedic surgery at a Canadian tertiary level 1 trauma centre from Jan. 1 to Mar. 31, 2020. Patient demographic characteristics, injury characteristics, delays until surgery and reasons for DOSCs were recorded.Results: A total of 185 patients (100 males and 85 females with a mean age of 54 yr) were included in the study. There were 98 outpatients and 87 inpatients. Seventy-five (40%) of the scheduled procedures in the outpatient group and 34 (30%) of those in the inpatient group were cancelled. In both groups, more than 85% of the cancellations were because of prioritization of a more urgent orthopedic or nonorthopedic surgical case. The average operative delay for the outpatient group was 11.4 days, compared to 3.8 days for the inpatient group (p < 0.001).Conclusion: High DOSC rates were observed among both outpatients and inpatients. The main reason for delaying surgery was prioritization of a more urgent surgical case. Providing the orthopedic trauma service with a dedicated OR opened 6 days per week, along with extended hours of OR services to 1700 daily, might be effective at minimizing DOSCs.