Evaluating the Reasons for Cancellations of Scheduled Elective Surgeries Requiring Postoperative Pediatric ICU Care: An Observational Study

Background: Pediatric intensive care units (PICUs) are essential for managing critically ill children who require advanced airway, respiratory, and hemodynamic support. Disease patterns vary across regions and over time, making regular reviews necessary for improving patient care. Auditing admissions and outcomes provides insights for refining clinical practices.Objective: This study aims to investigate the reasons for pediatric surgical admissions and the frequency and causes of surgical cancellations across specialties. This study aims to identify modifiable factors that could improve surgical efficiency and patient outcomes.Methods: A retrospective chart review was conducted at the Pediatric Department, King Abdulaziz University Hospital, from January 2019 to January 2020, including 211 pediatric patients. Data were collected from the neurosurgery, ENT, cardiothoracic, general, and urology departments.Results: Significant differences were observed between patients with cancelled surgeries and those with completed surgical procedures by specialty and by month of admission. Cancellation rates were higher in cardiology (80%), urology (71.4%), and general surgery (69.6%), specialties that frequently require postoperative PICU admission. Higher cancellations occurred in July (76%), September (72%), and December (61%), coinciding with reduced bed availability due to seasonal patient surges and staff rotations. In ENT cases, laryngeal conditions (27.1%) and subglottic stenosis (20.8%) were the most frequent indications for surgery. In neurology, brain tumors (25.3%) and hydrocephalus (22.7%) were the frequent diagnoses that resulted in surgery.Conclusion: The findings highlight that cancellation rates were highest in specialties such as cardiology, urology, and general surgery that frequently require postoperative PICU care. Peaks in July, September, and December also reflected periods of limited bed availability. Expanding PICU beds and optimizing scheduling in high-volume specialties may therefore directly reduce cancellations, improve resource utilization, and enhance patient outcomes. These steps would help to manage future patient influx and reduce surgery cancellation rates.