AAFPRS058 - Risk Factors for Same Day Surgery Cancellations in Head and Neck Reconstructive Surgery
Thursday, April 28, 2022
8:25 AM – 8:30 AM CT
Location: Landmark D
Natalie Derise, MD; James Stewart, BS; John Hunsicker, BS; William Carroll, MD; Jessica Grayson, MD
University of Alabama at Birmingham - Department of Otolaryngology (Derise, Carroll, Grayson); University of Alabama at Birmingham Medical School (Stewart, Hunsicker)
Background: Same day cancellation of major surgical procedures has a significant impact on patient care. There is limited data addressing these effects within Otolaryngology.
Learning Objectives: To identify disparities and characteristics that place patients at risk for last-minute surgery cancellations.
Study Objective: To compare characteristics of reconstructive cases cancelled within 24-hours of surgery to those that are successfully performed.
Design Type: Retrospective, case-control study.
Methods: A retrospective, case-control study was performed to assess for disparities that lead to same day cancellations amongst patients undergoing major head and neck reconstructive surgery. Data collected included patient demographics, comorbidities, clinical follow up, area deprivation index (ADI), and surgery and cancellation characteristics.
Results: 567 patients scheduled to undergo major head and neck reconstructive flap surgery were included in the study. 488 subjects underwent the scheduled surgery and 79 were cancelled within 24 hours of the scheduled start time. Patients with cancelled cases were found more likely than controls to have a higher ADI (p=0.054), history of prior head and neck cancer treatment (p<0.001), history of or current alcohol use (p=0.003), a longer time between the initial office visit and planned surgery (p=0.042), and were more likely inpatient versus outpatient at the time of surgery (p<0.001). The most common reasons for cancellation were patient no show/reschedule (34.2%), medically unnecessary (17.7%), and medical status change (16.5%).
Conclusion: Flap reconstruction in head and neck surgery is complex and requires significant resources. Understanding the multifactorial reasons for same-day cancellations is key in identifying and preventing poor resource utilization.