Day-of-Surgery Cancellations: A Prospective Study at Abo-Slim Trauma Hospital, Tripoli, Libya

الملخص

Same-day cancellations of elective surgeries compromise patient care and hospital efficiency. this study aimed to determine the
frequency and causes of such postponements in a tertiary trauma hospital.
A prospective observational study was conducted at Aboslim Trauma Hospital over a 6-month period (October 1, 2024 to March
31, 2025). All elective surgeries scheduled across five departments (General Surgery, Orthopedic Surgery, Neurosurgery, Plastic
Surgery, and Chest Surgery) were included. Postponements on the day of surgery were recorded by the chief scrub nurse, and
causes were categorized into: patient medical reasons, lack of operating time, administrative issues, patient no-shows, and changes
in surgical plan. A chi-square goodness-of-fit test was used to determine whether the distribution of causes differed significantly
from a uniform distribution.
Out of a total of 1,128 scheduled elective surgeries, 282 cases, representing 25% of the total, were postponed on the day of
operation. The most frequently cited reason for postponement was patient medical issues, accounting for 120 cases or 42.6%.
Lack of available operating time was responsible for 98 postponements, making up 34.8% of the total. Administrative issues,
such as scheduling errors or equipment unavailability, contributed to 43 cases (15.2%). Additionally, 12 patients (4.3%) failed
to attend on the day of surgery, and in 9 cases (3.1%), the surgical plan was altered, resulting in postponement. To determine
whether these reasons occurred with equal frequency or whether certain causes were disproportionately represented, a chi-square
goodness-of-fit test was conducted. The test yielded a chi-square statistic of 99.12 with four degrees of freedom and a P-value of
1.51 × 10⁻²⁰. This result indicates a highly significant deviation from a uniform distribution, confirming that some causes were
significantly more prevalent than others.
Most same-day surgery postponements were due to medical issues or scheduling inefficiencies, and were largely preventable.
Interventions aimed at improving preoperative assessments and realistic OR scheduling could substantially reduce cancellations.