Elective surgery cancellations: the experiences and reasons in a tertiary hospital in port Harcourt, Nigeria
DOI:
https://doi.org/10.18203/2349-2902.isj20262987Keywords:
Case cancellation, Experiences and reasons, Elective surgery, Nigeria, Port HarcourtAbstract
Background: Elective surgery cancellations have been reported in major centres in developed and developing economies and its occurrence is avoidable. This study explored the experiences and reasons for elective surgery cancellations and proffered solutions for improved service delivery at the Rivers State University Teaching Hospital.
Methods: A cross-sectional observational study was carried out among total population of consenting staff of Surgical Departments from April 2023 to March 2024. Self-administered questionnaire was used and data was analysed using SPSS.
Results: There were 66 (54.5%) male and 55 (45.5%) female respondents. Their mean age was 34.09±9.14 years and mean years of practice was 6.39±3.92 years. Ninety-one (75.2%) were aware of elective surgical cases cancellation and this varied from 1-3 per week (n=81; 66.9%), 4-6 per week (n=7; 5.8%), >6 per week (n=4; 3.3%). The most common reason for case cancellation was poor patient preparation (n=37; 30.6%), followed by financial challenges on the part of the patient (n=30%; 24.8%), etc. Patient-related factors, central sterile supply department (CSSD) factor, anaesthetists’ factor, surgeon's factor, perioperative nurses' factor, theatre technicians' and potters’ factor, were notable contributors. Suggestions were made relating to patients, staff and the hospital/government.
Conclusions: Multiple factors lead to occurrence of elective surgical case cancellations. Predominant reasons were poor patients’ preparation, brought about by patient-related and other factors. Joint efforts are recommended for mitigation.
References
Kumar R, Gandhi R. Reasons for cancellation of operation on the day of intended surgery in a multidisciplinary 500 bedded hospital. J Anaesthesiol Clin Pharmacol. 2012;28(1):66-9.
Al Talalwah N, McIltrot KH. Cancellation of surgeries: integrative review. J PeriAnesthesia Nursing. 2019;34(1):86-96.
Kaddoum R, Fadlallah R, Hitti E, El-Jardali F, El Eid G. Causes of cancellations on the day of surgery at a Tertiary Teaching Hospital. BMC Health Serv Res. 2016;16:1-8.
Abate SM, Chekole YA, Minaye SY, Basu B. Global prevalence and reasons for case cancellation on the intended day of surgery: a systematic review and meta-analysis. Int J Surg Open. 2020;26:55-63.
Schofield WN, Rubin GL, Piza M, Lai YY, Sindhusake D, Fearnside MR, et al. Cancellation of operations on the day of intended surgery at a major Australian referral hospital. Medical J Australia. 2005;182(12):612-5.
Koushan M, Wood LC, Greatbanks R. Evaluating factors associated with the cancellation and delay of elective surgical procedures: a systematic review. International J Quality Health Care. 2021;33(2):92.
Poeran J, Zhong H, Wilson L, Liu J, Memtsoudis SG. Cancellation of elective surgery and intensive care unit capacity in New York State: a retrospective cohort analysis. Anesthesia & Analgesia. 2020;131(5):1337-41.
Prin M, Eaton J, Mtalimanja O, Charles A. High elective surgery cancellation rate in Malawi primarily due to infrastructural limitations. World J Surg. 2018;42:1597-602.
Okonu NN. Cancellation of elective inpatient surgery at Kenyatta national hospital: University of Nairobi, Kenya. 2012.
Oluwadiya K, Olasinde A, Olakulehin O, Olatoke S, Oginni L, Ako F. The Causes and outcome of cancellation of orthopaedic surgeries at the Obafemi Awolowo University Teaching Hospital Complex Ile Ife Nigeria. Nig Postg Med J. 2007;14:42-4.
Tait AR, Voepel-Lewis T, Munro HM, Gutstein HB, Reynolds PI. Cancellation of pediatric outpatient surgery: economic and emotional implications for patients and their families. J Clin Anesth. 1997;9(3):213-9.
Ivarsson B, Ola Kimblad P, Sjöberg T, Larsson S. Patient reactions to cancelled or postponed heart operations. J Nursing Management. 2002;10(2):75-81.
Okeke C, Obi A, Tijani K, Eni U, Okorie C. Cancellation of elective surgical cases in a nigerian teaching hospital: Frequency and reasons. Nigerian J Clin Practice. 2020;23(7):965-9.
Kolawole IK, Bolaji BO. Reasons for cancellation of elective surgery in Ilorin. Nigerian J Surg Res. 2002;4(1):28-33.
Adesina OA, Ojikutu R, Opaleye T, Adesina OO, Idowu OS, Adebayo OK, et al. Cancellation of Elective Oral and Maxillofacial Surgery, a Tertiary Hospital Experience. J Maxillofac Oral Surg. 2023;3:1-6.
Magnusson H, Felländer-Tsai L, Hansson MG, Ryd L. Cancellations of elective surgery may cause an inferior postoperative course: the ‘invisible hand’of health-care prioritization. Clin Ethics. 2011;6(1):27-31.
Caesar U, Karlsson J, Olsson LE, Samuelsson K, Hansson-Olofsson E. Incidence and root causes of cancellations for elective orthopaedic procedures: a single center experience of 17,625 consecutive cases. Patient Saf Surg. 2014;8(1):24.
Koh WX, Phelan R, Hopman WM, Engen D. Cancellation of elective surgery: rates, reasons and effect on patient satisfaction. Canadian J Surgery. 2021;64(2):155.
Ostien P. Percentages by Religion of the 1952 and 1963 Populations of Nigeria's Present 36 States. Ostien, P,“Percentages By Religion of the 1952. 1963.
Ihejirika WC. Muslim minorities and media access in a predominantly Christian city: The case of Port Harcourt, Nigeria. J African Media Studies. 2009;1(3):469-91.
Gajida AU, Takai IU, Nuhu YN. Cancellations of elective surgical procedures performed at a Teaching Hospital in North-West Nigeria. J Med Tropics. 2016;18(2):108-12.
Sukwana A, Mrara B, Oladimeji O, editors. Prevalence and causes of elective surgical cancellations: findings from a rural tertiary hospital in the Eastern Cape, South Africa. Healthcare. 2023;11:270.
Getie A, Ayele B, Getie GA. Cancellation of elective surgery and its associated factors among scheduled patients at Debre Markos Comprehensive Specialized Hospital, Amhara Region, North West Ethiopia: a cross-sectional explanatory mixed-methods approach. BMJ Open. 2025;15(8):85156.
González‐Arévalo A, Gómez‐Arnau J, DelaCruz F, Marzal J, Ramírez S, Corral E, et al. Causes for cancellation of elective surgical procedures in a Spanish general hospital. Anaesthesia. 2009;64(5):487-93.
Santos GAACd, Bocchi SCM. Cancellation of elective surgeries in a Brazilian public hospital: reasons and estimated reduction. Revista brasileira de enfermagem. 2017;70:535-42.
Ogwal A, Oyania F, Nkonge E, Makumbi T, Galukande M. Prevalence and predictors of cancellation of elective surgical procedures at a tertiary hospital in uganda: a cross‐sectional study. Surgery Res Practice. 2020;2(1):1464098.
Chalya PL, Gilyoma J, Mabula JB, Simbila S, Ngayomela I, Chandika A, et al. Incidence, causes and pattern of cancellation of elective surgical operations in a university teaching hospital in the Lake Zone, Tanzania. African Health Sci. 2011;11(3):438.
Engidayehu T, Ayalew Y, Gela D, Abera F. Cancellation of elective surgery and its associated factors in public teaching hospitals of Addis Ababa, Ethiopia, 2021. SAGE Open. 2024;14(4):213519.
Ndeshipanda DJS. Frequency and factors associated with cancellation of elective surgical operations in Intermediate Hospital Oshakati: University of Namibia. 2025.
Mabila B, Mathunjwa-Dlamini T, Simatende P. Factors associated with elective surgery patient cancellation in Eswatini. Uneswa J Edu. 2023;6(1):13.
Michael AA, Edwin EO. Pattern of cancellation of elective cases. WORLD. 2024;24(3):703-19.
Solak AK, Pandza H, Beciragic E, Husic A, Tursunovic I, Djozic H. Elective case cancellation on the day of surgery at a general hospital in Sarajevo: causes and possible solutions. Materia Socio-Medica. 2019;31(1):49.
Caesar U, Karlsson L, Hamrin Senorski E, Karlsson J, Hansson‐Olofsson E. Delayed and cancelled orthopaedic surgery; are there solutions to reduce the complex set of problems. A systematic literature review. Int J Clin Pract. 2021;75(9):14092.