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

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  • معلومة اضافية
    • Affiliation:
      1 Health Services Research Centre, National Institute of Academic Anaesthesia, Royal College of Anaesthetists, London, UK
      2 UCL/UCLH Surgical Outcomes Research Centre (SOuRCe), Centre for Perioperative Medicine, Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK
      3 Bloomsbury Institute of Intensive Care Medicine, University College London, London, UK
    • Note:
      This article is accompanied by an editorial: Counting the cost of cancelled surgery: a system wide approach is needed by Gillies et al., Br J Anesth 2018:121:691–694, doi: 10.1016/j.bja.2018.08.002
      Handling editor: H.C. Hemmings Jr
      Editorial decision: 9 July 2018
    • Keywords:
      Health Services Research
      medical resource utilisation
      operating room management
      surgery
    • Abstract:
      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.
    • Abstract:
      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.
    • Abstract:
      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.
    • ISSN:
      0007-0912
    • Accession Number:
      10.1016/j.bja.2018.07.002
    • Accession Number:
      S0007091218305658
    • Copyright:
      © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.
  • Citations
    • ABNT:
      MOONESINGHE, W. H. B. B. C. D. F. G. G. L. W. S. R. D. J. N. S. K. J. O. M. S. L. D. J. J. D. et al. Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals. British Journal of Anaesthesia, [s. l.], v. 121, n. 4, p. 730–738, 2018. DOI 10.1016/j.bja.2018.07.002. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edselp&AN=S0007091218305658&custid=s8280428. Acesso em: 12 dez. 2019.
    • AMA:
      Moonesinghe WHBBCDFGGLWSRDJNSKJOMSLDJJD, Grocott SBBPSSAKNMRASCSRSMM, Cripps P, et al. Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals. British Journal of Anaesthesia. 2018;121(4):730-738. doi:10.1016/j.bja.2018.07.002.
    • APA:
      Moonesinghe, W. H. B. B. C. D. F. G. G. L. W. S. R. D. J. N. S. K. J. O. M. S. L. D. J. J. D., Grocott, S. B. B. P. S. S. A. K. N. M. R. A. S. C. S. R. S. M. M., Cripps, P., Research, A. F. of T. (RAFT), A. A. and R. M. of Y. (AARMY), I. C. & A. R. N. of N. E. T. (INCARNNET), M. A. G. for I. Q. (MAGIQ), M. E. R. by C. C. and A. T. (MERCAT), N. W. R. and A. G. (NWRAG), O. C. C. A. R. E. (OxCCARE), P.-L. P. A. & R. N. (PLAN), S. E. Q. I. & R. A. (SEQuoIA), S. Q. I. and R. N. (SQUARES), S. T. A. R. (STAR), S. W. A. R. M. (SWARM), S. Y. H. A. and R. C. (SHARC), S. P. A. and R. C. (SPARC), W. A. A. R. & E. N. (WAAREN), W. M. T. R. A. & I. C. N. (WMTRAIN), Rawat, S. C. A. B. B. B. C. C. C. E. E. G. G. H. H. H. J. J. J. J. M. M. N. P. P. Q. S. S. S. S. T. T. T. V. W. W. W. W.-Y. W. S. S. A. J. N. L. D. C. L. A. A. S. M. S. I. R. C. R. K. C. S. K. S. H. A. H. L. T. T. J. S. C. C. S. O. C. M. T. L. H., Moloney, C. C. C. E. F. P. T. D. C. J. B. Z. G. C. A., … Moonesinghe, S. R. (2018). Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals. British Journal of Anaesthesia, 121(4), 730–738. https://doi.org/10.1016/j.bja.2018.07.002
    • Chicago/Turabian: Author-Date:
      Moonesinghe, Wong, Harris, Bedford, Boney, Chazapis, Drake, Farmer, Gilhooly, Goodwin, Lourtie, Wagstaff, S. Ramani Danny J.N. Steve K. James Oliver Maria Sharon Laura David James Jose Duncan, Sneyd, Batchelor, Brett, Plowright, Shrestha, Shawyer, Ahmed, Khondoker, Nathanson, Mike Robert Anna Stephen Catherine Suman Richard Shafi Mizan Mike Grocott, Paul Cripps, Audit Federation of Trainees (RAFT), Anaesthetic Audit and Research Matrix of Yorkshire (AARMY), Intensive Care & Anaesthesia Research Network of North East Trainees (INCARNNET), Merseyside Anaesthetic Group for Improving Quality (MAGIQ), Midlands East Research by Critical Care and Anaesthetic Trainees (MERCAT), North West Research and Audit Group (NWRAG), Oxford Critical Care Anaesthetic Research Enterprise (OxCCARE), Pan-London Peri-operative Audit & Research Network (PLAN), Scottish East Quality Improvement & Research Academy (SEQuoIA), SESSA Quality Improvement and Research Network (SQUARES), Severn Trainees Anaesthetic Research (STAR), South West Anaesthetic Research Matrix (SWARM), South Yorkshire Hospitals Audit and Research Collaboration (SHARC), Southcoast Peri-operative Audit and Research Collaboration (SPARC), Welsh Anaesthetic Audit Research & Engagement Network (WAAREN), West Midlands Trainee Research Anaesthesia & Intensive Care Network (WMTRAIN) Research, Sathe, Campbell, Anandarajah, Ball, Bandara, Barnes, Chapman, Connor, Cook, Ebejer, Evans, Gallagher, Goff, Halfacree, Harford, Harris, Jackson, James, Jones, Jones, Malinovszky, Mungai, Nageswaran, Perumal, Pudge, Quinn, Sheppard, Smith, Spargo, Storton, Thomas, Thomas, Tyrrell, Vale, Williams, Williams, Williams, Winfield-Young, Worrell, Shilpa Sonia Alison Janakan Nicola Lalindra Dennis Catherine Lynda Amanda Amanda Samantha Maire Sarah Irina Rachel Catherine Rebecca Kathryn Claire Sharon Kathy Serah Hari Anand Harriet Leanne Thomas Trudy James Sharon Caradog Charlotte Samuel Owen Catrin Marie Tom Lewys Helen Rawat, Chuni, Comara, Conway, Eagle, Foster, Platt, Thorne, Dermot Chandini Jasna Brian Zara Greg Chris Alison Moloney, Armstrong, Brennan, Burns, Busby, Couch-Upite, Dooks, Dunlop, Eijk, Govindaraju, Gregory, Grover, Hairsine, Hennell, Hill, Hollins, Hood, Horner, Hothersall, Ingham, Jackson, Kitching, Kurasz, Munsie, Nemeth, Paley, Premraj, Redhead, Scriven, Shaw, Shenton, Shiva, Snell, Sootheran, Stewart, Swinton, Totten, Varghese, Vest, Wetherell, Wendy Lum Lisa Albert Justine Chantal Mechele Emma Sally Anya Ramana Tamsin Alka Brigid Sarah Philippa Thomas Julian Lisa Helen Rachel Richard Amy Claire Sarah Ildiko Carole Prabhakaran Sue John Alison Liz Hemantha Josie Lucy Josephine Frank Claire Liz Sarah Ben Hee, et al. 2018. “Cancelled Operations: A 7-Day Cohort Study of Planned Adult Inpatient Surgery in 245 UK National Health Service Hospitals.” British Journal of Anaesthesia 121 (4): 730–38. doi:10.1016/j.bja.2018.07.002.
    • Harvard:
      Moonesinghe, W. H. B. B. C. D. F. G. G. L. W. S. R. D. J. N. S. K. J. O. M. S. L. D. J. J. D. et al. (2018) ‘Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals’, British Journal of Anaesthesia, 121(4), pp. 730–738. doi: 10.1016/j.bja.2018.07.002.
    • Harvard: Australian:
      Moonesinghe, WHBBCDFGGLWSRDJNSKJOMSLDJJD, Grocott, SBBPSSAKNMRASCSRSMM, Cripps, P, Research, AF of T (RAFT), AA and RM of Y (AARMY), IC& ARN of NET (INCARNNET), MAG for IQ (MAGIQ), MER by CC and AT (MERCAT), NWR and AG (NWRAG), OCCARE (OxCCARE), P-LPA& RN (PLAN), SEQI& RA (SEQuoIA), SQI and RN (SQUARES), STAR (STAR), SWARM (SWARM), SYHA and RC (SHARC), SPA and RC (SPARC), WAAR& EN (WAAREN), WMTRA& ICN (WMTRAIN), Rawat, SCABBBCCCEEGGHHHJJJJMMNPPQSSSSTTTVWWWW-YWSSAJNLDCLAASMSIRCRKCSKSHAHLTTJSCCSOCMTLH, Moloney, CCCEFPTDCJBZGCA, Hee, ABBBC-UDDEGGGHHHHHHHIJKKMNPPRSSSSSSSSTVVWWLLAJCMESARTABSPTJLHRRACSICPSJALHJLJFCLSB, Hamlyn, TABDEFFGGHHJLOOTTWWVJTPKLPECURSHSAEFMRJ, MacGregor, ACFGGKLPSSTTWMCMVRCACBLCHEM, Qadri, ABCGGIPRRSSTNSRCLHCJN, Chaurasia, BCDGHJOPZSKJMAEANPSL, Torrance, AGRAABBFF-JGGHJJMMMMMMMNNOPPRSSSTTVRWWWWHSMATLKEJTTLRBHSCRTAOEMHMCCKZDMCTPGSFPD, Armanious, ABBCKOPRSSVSKSKRAMAJLAM, Knowlden, DGGHILL-WMPR-MTVPBPGHMCBDSSMP, McCourt, BCMMKNCJA, Pugh, 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CKSABBBCCDDEFGGGHKLMMMMNPRTWWCYGSORJLSMHJTPAKJDSNRCJAASATCVADAW, et al. 2018, ‘Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals’, British Journal of Anaesthesia, vol. 121, no. 4, pp. 730–738, viewed 12 December 2019, .
    • MLA:
      Moonesinghe, Wong, Harris, Bedford, Boney, Chazapis, Drake, Farmer, Gilhooly, Goodwin, Lourtie, Wagstaff, S.Ramani Danny J. N.Steve K.James Oliver Maria Sharon Laura David James Jose Duncan, et al. “Cancelled Operations: A 7-Day Cohort Study of Planned Adult Inpatient Surgery in 245 UK National Health Service Hospitals.” British Journal of Anaesthesia, vol. 121, no. 4, Oct. 2018, pp. 730–738. EBSCOhost, doi:10.1016/j.bja.2018.07.002.
    • Chicago/Turabian: Humanities:
      Moonesinghe, Wong, Harris, Bedford, Boney, Chazapis, Drake, Farmer, Gilhooly, Goodwin, Lourtie, Wagstaff, S. Ramani Danny J.N. Steve K. James Oliver Maria Sharon Laura David James Jose Duncan, Sneyd, Batchelor, Brett, Plowright, Shrestha, Shawyer, Ahmed, Khondoker, Nathanson, Mike Robert Anna Stephen Catherine Suman Richard Shafi Mizan Mike Grocott, Paul Cripps, Audit Federation of Trainees (RAFT), Anaesthetic Audit and Research Matrix of Yorkshire (AARMY), Intensive Care & Anaesthesia Research Network of North East Trainees (INCARNNET), Merseyside Anaesthetic Group for Improving Quality (MAGIQ), Midlands East Research by Critical Care and Anaesthetic Trainees (MERCAT), North West Research and Audit Group (NWRAG), Oxford Critical Care Anaesthetic Research Enterprise (OxCCARE), Pan-London Peri-operative Audit & Research Network (PLAN), Scottish East Quality Improvement & Research Academy (SEQuoIA), SESSA Quality Improvement and Research Network (SQUARES), Severn Trainees Anaesthetic Research (STAR), South West Anaesthetic Research Matrix (SWARM), South Yorkshire Hospitals Audit and Research Collaboration (SHARC), Southcoast Peri-operative Audit and Research Collaboration (SPARC), Welsh Anaesthetic Audit Research & Engagement Network (WAAREN), West Midlands Trainee Research Anaesthesia & Intensive Care Network (WMTRAIN) Research, Sathe, Campbell, Anandarajah, Ball, Bandara, Barnes, Chapman, Connor, Cook, Ebejer, Evans, Gallagher, Goff, Halfacree, Harford, Harris, Jackson, James, Jones, Jones, Malinovszky, Mungai, Nageswaran, Perumal, Pudge, Quinn, Sheppard, Smith, Spargo, Storton, Thomas, Thomas, Tyrrell, Vale, Williams, Williams, Williams, Winfield-Young, Worrell, Shilpa Sonia Alison Janakan Nicola Lalindra Dennis Catherine Lynda Amanda Amanda Samantha Maire Sarah Irina Rachel Catherine Rebecca Kathryn Claire Sharon Kathy Serah Hari Anand Harriet Leanne Thomas Trudy James Sharon Caradog Charlotte Samuel Owen Catrin Marie Tom Lewys Helen Rawat, Chuni, Comara, Conway, Eagle, Foster, Platt, Thorne, Dermot Chandini Jasna Brian Zara Greg Chris Alison Moloney, Armstrong, Brennan, Burns, Busby, Couch-Upite, Dooks, Dunlop, Eijk, Govindaraju, Gregory, Grover, Hairsine, Hennell, Hill, Hollins, Hood, Horner, Hothersall, Ingham, Jackson, Kitching, Kurasz, Munsie, Nemeth, Paley, Premraj, Redhead, Scriven, Shaw, Shenton, Shiva, Snell, Sootheran, Stewart, Swinton, Totten, Varghese, Vest, Wetherell, Wendy Lum Lisa Albert Justine Chantal Mechele Emma Sally Anya Ramana Tamsin Alka Brigid Sarah Philippa Thomas Julian Lisa Helen Rachel Richard Amy Claire Sarah Ildiko Carole Prabhakaran Sue John Alison Liz Hemantha Josie Lucy Josephine Frank Claire Liz Sarah Ben Hee, et al. “Cancelled Operations: A 7-Day Cohort Study of Planned Adult Inpatient Surgery in 245 UK National Health Service Hospitals.” British Journal of Anaesthesia 121, no. 4 (October 1, 2018): 730–38. doi:10.1016/j.bja.2018.07.002.
    • Vancouver/ICMJE:
      Moonesinghe WHBBCDFGGLWSRDJNSKJOMSLDJJD, Grocott SBBPSSAKNMRASCSRSMM, Cripps P, Research AF of T (RAFT), AA and RM of Y (AARMY), IC& ARN of NET (INCARNNET), MAG for IQ (MAGIQ), MER by CC and AT (MERCAT), NWR and AG (NWRAG), OCCARE (OxCCARE), P-LPA& RN (PLAN), SEQI& RA (SEQuoIA), SQI and RN (SQUARES), STAR (STAR), SWARM (SWARM), SYHA and RC (SHARC), SPA and RC (SPARC), WAAR& EN (WAAREN), WMTRA& ICN (WMTRAIN), Rawat SCABBBCCCEEGGHHHJJJJMMNPPQSSSSTTTVWWWW-YWSSAJNLDCLAASMSIRCRKCSKSHAHLTTJSCCSOCMTLH, Moloney CCCEFPTDCJBZGCA, et al. Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals. British Journal of Anaesthesia [Internet]. 2018 Oct 1 [cited 2019 Dec 12];121(4):730–8. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edselp&AN=S0007091218305658&custid=s8280428