Matzek Luke J, Smith Bradford B, Mauermann William J, Bower Thomas C, Smith Mark M
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
Department of Vascular Surgery, Mayo Clinic, Rochester, MN.
Ann Vasc Surg. 2020 Jan;62:349-355. doi: 10.1016/j.avsg.2019.06.036. Epub 2019 Aug 23.
Same-day cancellation of vascular surgical procedures is an undesirable occurrence with multifaceted implications into the patient's health care. Numerous factors play a role in same-day cancellations, ranging from medical causes, patient factors, or administrative and scheduling conflicts.
A retrospective review of the medical records database at our large tertiary academic referral center from 2007 to 2017 was performed to identify patients scheduled for vascular surgical procedures who experienced same-day cancellation.
Of the 17,887 scheduled vascular surgical procedures during the study period, 361 (2%) patients experienced same-day cancellations. Seventy-five percent of cancellations were determined to be nonforeseeable, 12.5% foreseeable, and 12.5% indeterminate. The most common reasons for cancellation were medical (55%), patient-initiated cancellation (12%), procedure no longer required (10%), and administrative or scheduling conflicts (10%). Twenty-six (7.3%) patients died within 30 days after their cancelled vascular operation. Most patients (69%) eventually received the planned operation, with a mean interval of 45.5 ± 135.8 days between cancellation and performance of the aforementioned procedure.
At our institution, same-day cancellations of vascular surgical procedures were infrequent (2%). Most cancellations were due to medical reasons. Although most cancellations were determined to be nonforeseeable, emphasizing foreseeable cancellations may provide opportunities to improve patient care, enhance satisfaction, and reduce future cancellations.
血管外科手术当日取消是一种不良事件,对患者的医疗保健有多方面影响。许多因素导致手术当日取消,包括医学原因、患者因素或行政及排班冲突。
对我们大型三级学术转诊中心2007年至2017年的病历数据库进行回顾性研究,以确定计划进行血管外科手术但手术当日取消的患者。
在研究期间计划进行的17,887例血管外科手术中,361例(2%)患者手术当日取消。75%的取消被确定为不可预见,12.5%为可预见,12.5%为不确定。取消的最常见原因是医学原因(55%)、患者主动取消(12%)、不再需要手术(10%)以及行政或排班冲突(10%)。26例(7.3%)患者在取消血管手术后30天内死亡。大多数患者(69%)最终接受了计划的手术,取消与上述手术实施之间的平均间隔为45.5±135.8天。
在我们机构,血管外科手术当日取消情况不常见(2%)。大多数取消是由于医学原因。虽然大多数取消被确定为不可预见,但强调可预见的取消可能为改善患者护理、提高满意度和减少未来取消提供机会。