Henderson Bonnie A, Naveiras Miguel, Butler Nicholas, Hertzmark Ellen, Ferrufino-Ponce Zandra
Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, 02114, USA.
J Cataract Refract Surg. 2006 Jan;32(1):95-102. doi: 10.1016/j.jcrs.2005.11.013.
To report the incidence and analyze potentially preventable causes of ocular surgery cancellations.
Ambulatory Care Surgical Center of the Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
A retrospective review of the ambulatory surgical center cancellation records and patient medical records from December 2001 to December 2003 was conducted. The primary statistical analysis was conditional logistic regression.
Three hundred seventy-nine of 7153 (5.3%) ambulatory ophthalmic surgeries were cancelled within 24 hours of the scheduled start time. Cancellation rates varied by patient age, with the rate among children being highest (8.7%) and that among older patients (age 60+) lowest (4.9%; P = .08). Surgeons who performed at least 4 surgeries per month on average had the lowest cancellation rate (P = .08). Cancellations occurred less frequently in warmer months (June, 3.3%; August, 4.2%) than during the rest of the seasons (P<.001). The highest incidence of cancellations occurred in February (7.8%) and the lowest in June (3.3%). Of the total causes, 41% were considered "preventable," 45% "unpreventable," and 14% "no reason given." Cancellations deemed preventable were lower in general anesthesia cases (1.0%) than in local anesthesia cases (2.0%; P = .02). Preventable cancellation rates also varied by procedure and were statistically significant.
Among ambulatory ophthalmic surgeries, there was a higher incidence of late cancellations in pediatric cases. Late cancellation rates were highest in cases scheduled in the winter, especially in February. Of the reasons documented for cancellations, 41% were considered "preventable" with proper preoperative counseling and instructions. The costs of late cancellations to the particular institution are estimated to be at least $100 000 per year, or nearly 1 month of scheduled surgeries in a 2-year period.
报告眼科手术取消的发生率，并分析其潜在可预防的原因。
美国马萨诸塞州波士顿市马萨诸塞眼耳医院门诊护理手术中心。
对2001年12月至2003年12月期间门诊手术中心的取消记录和患者病历进行回顾性研究。主要统计分析采用条件逻辑回归。
在7153例门诊眼科手术中，有379例（5.3%）在预定开始时间的24小时内被取消。取消率因患者年龄而异，儿童的取消率最高（8.7%），老年患者（60岁及以上）的取消率最低（4.9%；P = 0.08）。平均每月至少进行4台手术的外科医生取消率最低（P = 0.08）。与其他季节相比，温暖月份（6月，3.3%；8月，4.2%）取消手术的情况较少（P<0.001）。取消率最高发生在2月（7.8%），最低发生在6月（3.3%）。在所有原因中，41%被认为是“可预防的”，45%是“不可预防的”，14%是“未说明原因”。全身麻醉病例中被认为可预防的取消率（1.0%）低于局部麻醉病例（2.0%；P = 0.02）。可预防的取消率也因手术程序而异，且具有统计学意义。
在门诊眼科手术中，儿科病例的晚期取消发生率较高。冬季安排的手术，尤其是2月的手术，晚期取消率最高。在记录的取消原因中，41%被认为通过适当的术前咨询和指导是“可预防的”。特定机构因晚期取消造成的成本估计每年至少为10万美元，或在两年期间接近1个月的预定手术量。
