Unexpected Events That Occur in Patients on the Day of Surgery: A Single-center, Prospective Observational Study.

Abstract

Purpose: The purpose of this study is to investigate the reasons for case cancellations on the day of surgery and determine the rates of unexpected events and case cancellations.

Design: This is a prospective, cross-sectional study conducted at a single hospital.

Methods: The patients' reasons for surgical cancellation were classified as preventable or nonpreventable. Patient data were obtained in the operating room after standard anesthesia monitoring by anesthesiologists. Unexpected problems that emerged in patients and cases canceled due to these problems were recorded. We evaluated blood pressure values according to the American College of Cardiology and American Heart Association guidelines.

Findings: Elective surgery was planned for a total of 4,287 patients. The incidence of an unexpected event detected on the day of surgery was 5.8% (n = 250), and the case cancellation rate was 2.16%. Examination or medical condition-related factors (n = 78, 83.9%) were the most common reason for case cancellation. Among the 250 unexpected events, patients with undiagnosed hypertension were in the majority (n = 130, 52%). Severe hypertension was observed in 30 patients (12%) who were previously diagnosed with hypertension, and the surgery was canceled in 25 (83.3%) of these (P < .001).

Conclusions: Preventable causes (60.2%) were more common than nonpreventable ones among case cancellations. Our findings showed that many patients had high blood pressure and were unaware of this condition. Our study allowed referral of patients to a cardiologist to begin the follow-up process. Additionally, our study highlights the need for adequate preoperative anesthesia preparation and comprehensive nursing care.