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dc.contributor.authorNariani, Jaya
dc.contributor.authorClark, Sam
dc.contributor.authorDuniec, Larysa
dc.date.accessioned2019-02-08T15:20:10Z
dc.date.available2019-02-08T15:20:10Z
dc.date.issued2018en
dc.identifier.citationWong DJN, Harris SK, Moonesinghe SR, collaborators S-E, Health Services Research Centre NIoAA, Study Steering G, et al. Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals. Br J Anaesthesia. 2018 Oct;121(4):730-8.en
dc.identifier.pmid30236235en
dc.identifier.doi10.1016/j.bja.2018.07.002en
dc.identifier.urihttp://hdl.handle.net/10541/621537
dc.description.abstractBACKGROUND: 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. METHODS: We conducted a prospective observational cohort study over 7 consecutive days in March 2017 in 245 NHS hospitals. Occurrences and reasons for previous surgical cancellations were recorded. Using multilevel logistic regression, we identified patient- and hospital-level factors associated with cancellation due to inadequate bed capacity. 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. 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.en
dc.language.isoenen
dc.relation.urlhttps://dx.doi.org/10.1016/j.bja.2018.07.002en
dc.titleCancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitalsen
dc.typeArticleen
dc.contributor.departmentHealth Services Research Centre,National Institute of Academic Anaesthesiaen
dc.identifier.journalBritish Journal of Anaesthesiaen
dc.description.noteen]


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