Characteristics of Pediatric Urology Patients With Same-Day Surgery Cancellations: Who Is at Risk?

Abstract

Introduction

Day-of-surgery cancellations (DOSC) negatively impact patients, health-care providers, and systems. We assessed whether patient demographics, level of community disadvantage, and travel distance are associated with DOSC.

Methods

We retrospectively reviewed all elective outpatient urology surgery from January 2021 to June 2023. We collected patients' demographics, travel distance, diagnosis, and level of community disadvantage using the Area Deprivation Index (ADI). Patients with and without DOSC were compared.

Results

Of 516 scheduled surgeries, 26 cases (5.0%) were DOSC. One patient had two DOSC. Children with completed and canceled surgeries were similar in age (2.85 versus 1.89 ys, P = 0.71). Reasons for DOSC included: medical problem (9/26; 34.6%), no longer desired surgery (4/26; 15.4%), needed more information (2/26; 7.7%); confused about logistics (2/26; 7.7%); did not arrive (7/26; 26.9%); insufficient fasting (2/26; 7.7%). Patients using a language other than English for care were equally likely to cancel compared to patients who spoke English (5.9% versus 5.0%, adjusted odds ratio [OR] = 2.06, 95% confidence interval [CI]: 0.53-7.98; P = 0.29). Children living in most disadvantaged areas (ADI 9-10) and children living in the least disadvantaged areas (ADI 1-2) were equally likely to have surgery canceled, though 6.1% of patients with DOSC lived in ADI 9-10, and no children living in ADI 1-2 canceled. Compared with White non-Hispanic patients (10/226 [4.4%] DOSC), Black patients had similar DOSC (2/14 [14.3%], adjusted OR = 2.91, 95% CI: 0.55-15.36, P = 0.26), though Hispanic patients had a lower likelihood of DOSC (6/190 [3.2%], adjusted OR = 0.45, 95% CI: 0.13-1.54, P = 0.02). The likelihood of DOSC was similar for patients living more than 45 miles away (3.9% [10/258]) compared with those living within 20 miles (14/214 [6.5%]; adjusted OR = 0.49, 95% CI: 0.2-1.19, P = 0.51).

Conclusions

Patients living further away or speaking languages other than English are not more likely to have DOSC. Further investigation may identify patient- and community-specific factors influencing DOSC.