Mark M Smith1, William J Mauermann1, David J Cook2, Joseph A Hyder3, Joseph A Dearani4, David W Barbara5. 1. Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minn. 2. Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minn; Center for the Science of Health Care Delivery, Mayo Clinic College of Medicine, Rochester, Minn. 3. Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minn; Department of Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, Minn. 4. Division of Cardiovascular Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minn. 5. Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minn; Department of Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, Minn. Electronic address: Barbara.David@mayo.edu.
Abstract
BACKGROUND: Same-day cancellations of cardiac surgery are unfortunate and costly occurrences that potentially place patients at risk of adverse events. METHODS: We retrospectively reviewed all same-day cancellations of cardiac operations requiring cardiopulmonary bypass from 2010 to 2012 at a large academic tertiary referral center. RESULTS: Of 7081 cardiac operations, 134 patients experienced 142 same-day cancellations of cardiac surgery. The foreseeable cancellation causes comprised 17% of cancellations, nonforeseeable 59%, and indeterminate 24%. The reasons for cancellation were medical (51%), administrative or scheduling (17%), unknown (12%), procedure no longer required (11%), patient cancellation (6%), and preincisional complication (3%). The mean interval from the patient seeing a nonsurgeon provider to cancellation was 8.6 ± 16.2 days. No statistically significant differences existed between the foreseeable and nonforeseeable cancellations and the timing of the visit to a nonsurgeon provider (15, 30, 45, and 60 days) before cancellation. Seven patients (5%) had died within 30 days of cancellation. Of those subsequently operated on, the mean interval from cancellation to performance of the operation was 12.2 ± 22.7 days. Of the 142 cancelled surgical procedures, 28 (20%) were never subsequently performed. CONCLUSIONS: Same-day cancellation of cardiac surgery occurred infrequently (2% of cardiac operations performed) at our institution. The cancellations were for foreseeable causes in a few cases. Seeing a nonsurgeon provider more recently before cancellation was not significantly associated with nonforeseeable versus foreseeable cancellations. Although uncommon at our institution, same-day cancellations should be viewed as an opportunity for practice improvement, given the foreseeable nature of some cancelations, associated 30-day mortality, and portion of patients not subsequently undergoing cardiac surgery.
BACKGROUND: Same-day cancellations of cardiac surgery are unfortunate and costly occurrences that potentially place patients at risk of adverse events. METHODS: We retrospectively reviewed all same-day cancellations of cardiac operations requiring cardiopulmonary bypass from 2010 to 2012 at a large academic tertiary referral center. RESULTS: Of 7081 cardiac operations, 134 patients experienced 142 same-day cancellations of cardiac surgery. The foreseeable cancellation causes comprised 17% of cancellations, nonforeseeable 59%, and indeterminate 24%. The reasons for cancellation were medical (51%), administrative or scheduling (17%), unknown (12%), procedure no longer required (11%), patient cancellation (6%), and preincisional complication (3%). The mean interval from the patient seeing a nonsurgeon provider to cancellation was 8.6 ± 16.2 days. No statistically significant differences existed between the foreseeable and nonforeseeable cancellations and the timing of the visit to a nonsurgeon provider (15, 30, 45, and 60 days) before cancellation. Seven patients (5%) had died within 30 days of cancellation. Of those subsequently operated on, the mean interval from cancellation to performance of the operation was 12.2 ± 22.7 days. Of the 142 cancelled surgical procedures, 28 (20%) were never subsequently performed. CONCLUSIONS: Same-day cancellation of cardiac surgery occurred infrequently (2% of cardiac operations performed) at our institution. The cancellations were for foreseeable causes in a few cases. Seeing a nonsurgeon provider more recently before cancellation was not significantly associated with nonforeseeable versus foreseeable cancellations. Although uncommon at our institution, same-day cancellations should be viewed as an opportunity for practice improvement, given the foreseeable nature of some cancelations, associated 30-day mortality, and portion of patients not subsequently undergoing cardiac surgery.
Authors: Dongbo Yu; Isla S McClelland; Sarah Flahive; Abdulrahman Dia; Victor Mor-Avi; Roberto M Lang; R Parker Ward Journal: J Am Soc Echocardiogr Date: 2020-08-11 Impact factor: 5.251
Authors: Bart Scheenstra; Anouk M A Princée; Maike S V Imkamp; Bas Kietselaer; Yuri M Ganushchak; Arnoud W J Van't Hof; Jos G Maessen Journal: Eur J Cardiothorac Surg Date: 2021-12-27 Impact factor: 4.191