Day of Surgery Admission in Total Joint Arthroplasty:Why Are Surgeries Cancelled? An Analysis of 3195 PlannedProcedures and 114 Cancellations

Day of surgery admission (DOSA) is becoming standard practice as a means of reducing cost in total joint arthroplasty.Aims. The aim of our study was to audit the use of DOSA in a specialty hospital and identify reasons for cancellation.Methods.Aret-rospective study of patients presenting for hip or knee arthroplasty between 2008 and 2013 was performed. All patients were assessedat the preoperative assessment clinic (PAC).Results.Of3195patientsdeemedfitforsurgery,114patients(3.5%)hadtheirsurgerycan-celled. Ninety-two cancellations (80%) were due to the patient being deemed medically unsuitable for surgery by the anaesthetist.Cardiac disease was the most common reason for cancellation (𝑛=27), followed by pulmonary disease (𝑛=22). 77 patients (67.5%)had their operation rescheduled and successfully performed in our institution at a later date.Conclusion. DOSA is associated witha low rate of cancellations on the day of surgery. Patients with cardiorespiratory comorbidities are at greatest risk of cancellation.