Cancellations in Cardiac Surgery: Predictable, Dangerous and Avoidable?

  • #AC/VAL 02-EP-3
  • Adult Cardiac Surgery/Valves. E-POSTER (ORAL) SESSION 2
  • Oral

Cancellations in Cardiac Surgery: Predictable, Dangerous and Avoidable?

Edward J. Caruana 1, Katerina Konstantinidi 2, Pete Allsopp 1, Sally Highton 1, Adam Szafranek 1, Selveraj Shanmuganathan 1

Nottingham University Hospitals, Nottingham, United Kingdom; Medical School, Nottingham University, Nottingham, United Kingdom;

Date, time and location: 2018.05.25 13:30, Exhibition area, 1st Floor. Zone – D



Theatre cancellations are costly, distressing to patients, and may result in poorer outcomes. We sought to evaluate the determinants, incidence, outcomes and documentation practices surrounding cardiac surgical theatre cancellations at a single UK institution.


Patients cancelled following final theatre listing, between March 2016 and February 2017, were identified from administrative databases. Cancellation data was collected retrospectively from individual case-records, and documentation practices audited against the AAGBI Guidelines on Theatre Efficiency (2003). Perioperative and survival data was obtained from national databases. Statistical analysis was performed in Analyse-it for Microsoft Excel.


487 (94.2%) non-emergent procedures were performed, with 45 cancellations in 43 patients (cancellation rate: 9.2%); and resulting in a 16% increase in interval wait from angiogram to surgery. Only 6 cancellations (13.1%) were documented in full accordance with the relevant guidance.

Age (p=0.88), gender (p=0.38) and EuroSCORE II (p=0.60), day of the week (p=0.14) and consultant surgeon (p=0.29) had no impact on likelihood of cancellation. Cancellation rates varied by month (p=0.038, highest in January (19.4%) and lowest in October (2.1%)). 82% (n=37) of cancellations were due to hospital-causes; primarily bed-staffing availability (40.5%) and emergency cases (37.8%). Cancellation was associated with a higher in-hospital mortality (n=3) (6.7 vs 1.6%, p =0.044), but this normalised 6 months post-operatively (p=0.19). 5 cancellations (11.1%) were foreseeable and preventable.


Surgical cancellations are common, with only a small proportion being foreseeable and preventable. Documentation practices surrounding cancellations are poor. Cancellation may be associated with poorer short-term outcome; however, this effect needs further evaluation in a larger cohort.

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