Incidence and reasons for cancellation on the day of elective surgery: a systematic review and meta‐analysis
Authors' conclusion
Cancellation on the day of surgery remains a substantial and globally relevant peri-operative problem. Its burden and drivers are highly context-dependent and often reflect weaknesses in pre-operative preparation, organisational co-ordination and system capacity. Reducing avoidable cancellations may therefore require context-specific strategies targeting pathway reliability, timely pre-anaesthetic assessment and peri-operative resource alignment.
Study context
- Population
- Studies of elective surgery reporting cancellation on the day of surgerystudies with a strict definition of on-the-day cancellation included in the meta-analysis, of 58 meeting the eligibility criteria
- Participants
- 37 studies
- Outcome
- Pooled incidence of cancellation on the day of surgery
Methodological detailsrandom-effects meta-analysis of proportions, observational studies, Joanna Briggs Institute critical appraisal tools
- Random-effects meta-analysis of proportions
- Observational studies
- Joanna Briggs Institute critical appraisal tools
Pooled result
As reported in the abstract
Pooled incidence
14%
95%CI 13–16%
Heterogeneity
I2 = 99.91%
Further pooled results
Variation by national income level and surgical speciality (subgroup)
- Higher estimates in low- and lower-middle-income settings and in some specialities, including ophthalmology and neurosurgery
Reasons for cancellation
- Most common: patient declining surgery; non-fasted; unstable medical condition; changes in clinical status; improper scheduling or overbooking; instrument unavailability; and staff shortages
Sensitivity analyses and publication bias
- Sensitivity analyses supported the robustness of the findings and no clear publication bias was detected
Original publication
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