Reasons for Day-of-Surgery Cancellation of Elective Surgical Procedures During the COVID-19 Pandemic Compared to Pre- and Post-COVID-19 Periods

Introduction: With the emergence of the global pandemic caused by SARS-CoV-2, health service providers were put to the test. The utilization of operating theatres is one of the prime indicators of the logistic and organizational efficacy of a hospital. We performed an analysis evaluating the impact of the COVID-19 pandemic on the fluidity of providing surgical care to a patient with severe comorbidities and the organizational efficacy of the operating theater in a university hospital in northern Poland.

Methods: Casemix between the periods was tested and Fisher's test was used to examine the significance of the association between (i) patient, (ii) workup, (iii) resource/facility, and (iv) bed-related causes of day-of-surgery cancellations in pre- and post-COVID-19 pandemic periods and early- and medium-COVID-19 pandemic periods.

Results: In the study period, a total of 1,935 elective surgeries were booked, 2,219 elective and emergency surgeries were performed, and there were 203 (10.5%) cancellations. Patient-related cancellations increased significantly during the COVID-19 pandemic, accounting for 18.8% of cancellations, compared to 5.1% in pre- and post-pandemic periods (p = 0.0115). Resource/facility-related reasons remained the most frequent cause, contributing to 57.3% of cancellations during the pandemic.

Conclusions: Patient-related causes were the most frequent reasons in the COVID-19 pandemic period. Furthermore, patient-related reasons may have contributed to a drop in demand for surgical care and a nonsignificant change in the correlation between demand and supply for surgical care. The further effects of the COVID-19 pandemic on surgical department work are yet to be observed and should be reported to find a solution for growing societies' need for surgical care and find tools to minimize the "damage" caused by the next crisis in global healthcare.