Cancellation of elective cases in pediatric surgery: An audit.
OBJECTIVE
To determine the main reasons for cancellation of elective cases on scheduled date of surgery in pediatric patients.


METHODS
The audit was conducted in a 216 beds tertiary care pediatric super-specialty hospital. Two operation theatres (OT) provide elective surgical services to pediatric surgery, orthopedics, ophthalmology and otorhinolaryngology. The audit included all those patients who were posted for elective surgery over a period of one year. Cancelled cases were identified from predesigned OT utilization formats and the reasons for cancellation were evaluated.


RESULTS
A total of 2473 cases were posted for the elective surgery in the year 2009 and 189 (7.64%) patients had their surgery cancelled. The main reasons for cancellation were upper respiratory infections (30.68%) and shortage of time (29%). Other reasons were medically unfit patients (15.34%), precedence of emergency cases (3.7%); non-availability of ventilator and intensive care bed (4.7%); no-show by patient (4.76%); non-availability of blood (4.2%); incomplete work up (2.64%); administrative reasons (1.58%); patient not fasting (1.58%) and unspecified reasons (2.1%). Overall, 38.6% causes were preventable.


CONCLUSIONS
Elective surgery cancellation is a significant problem with multifactorial etiology. Most common reasons for cancellation of planned surgery were sudden onset of respiratory tract infection in the admitted patient and shortage of time. It suggests that on many occasions, surgeons take more time than anticipated for performing the procedure.
Department of Anaesthesiology, Chacha Nehru Bal Chikitsalaya, Affiliated to Maulana Azad Medical College, Geeta Colony, Delhi - 110 031, India.
Sapna
S
Bathla
Anup
A
Mohta
Aikta
A
Gupta
Geeta
G
Kamal