Background: The operating theatre is the most important department of a hospital as it involves significant resources. One of the significant obstacles in overseeing a theater managing system is scheduled elective case cancellation.

Objective: The present study was conducted to identify preventable reasons for cancellation.

Materials and Methods: A retrospective study was conducted between January and December 2018. Data from scheduled elective cases were retrieved from a database of the Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University. All patients who required anesthetization for surgery were divided into two groups, proceeding with the operation, and case cancellation. Baseline characteristics of the two groups were compared using the chi-square test, Fisher’s exact test, and analysis of variance. All statistical analyses were performed using the R software, and the correlation was considered significant at p of less than 0.05. The reason for case cancellations was categorized into three groups, preventable, unpreventable, inconclusive, then displayed as percentages.

Results: In all, 12,423 patients were identified as being scheduled elective cases. The case cancellation rate was 6.4%. Cancellation rates of males and females were 7.3% and 5.6%, respectively. Patients aged 65 to 79 years exhibited a 7.6% cancellation rate, and the cancellation rate was the highest at 17.3% in the American Society of Anesthesiologists (ASA) physical status classification 4. Of the 797 canceled surgeries, 397 cases (50%) were preventable, 192 cases (24%) were unpreventable, and 208 cases (26%) involved inconclusive reasons. The preventable reasons for cancellation comprised incomplete medical evaluations in 179 cases (22.5%), overtime in 74 cases (9.3%), and the patient refused surgery in 52 cases (6.5%).

Conclusion: The most common cause of elective case cancellation is an incomplete preoperative evaluation, which is a preventable reason.Therefore, preoperative evaluation protocol as a one-stop service preoperative clinic should be established to prevent and decrease the cancellation rate of elective cases.

Keywords: Cancellation case; Elective surgery; Preventable reason

DOI: 10.35755/jmedassocthai.2022.07.13336

Received 5 January 2022 | Revised 8 February 2022 | Accepted 14 February 2022