Predictors of cancellation and rescheduling of elective shoulder arthroscopy: Experiences at an urban academic medical center

BACKGROUND: Cancellation of elective shoulder arthroscopy negatively affects the surgical scheduling process and results in significant financial loss for a health care institution. Despite this, the patient-related and surgical-related risk factors of cancellation remain undefined. METHODS: A retrospective review at a single inner-city urban tertiary-care medical center was undertaken, including consecutive non-instability shoulder arthroscopy procedures from January 2016 through March 2024. Patient demographics and surgical data, including age at booking, marital status, diagnosed depression and/or anxiety, insurance type, distance from home to clinic, socioeconomic status, and history of ipsilateral and contralateral shoulder surgery, were tabulated. Cases were categorized as noncancelled, cancelled rescheduled, and cancelled not rescheduled. The time between booking and cancellation, in addition to the specific reason for cancellation, was documented. RESULTS: A total of 756 consecutive cases were reviewed, of which 210 (27.8%) were cancelled before the planned surgical date. The cohort consisted of 399 women (52.8%) with a median age at booking of 56 years (IQR 51, 62). Of the cancellations, 90 (42.8%) rescheduled and underwent arthroscopy after a median of 111 days (IQR 23, 134). A history of ipsilateral cancellation (odds ratio [OR] 14.80, 95% confidence interval [CI] 4.88-44.89, P < .001), missing an outpatient visit before surgery (OR 1.57, 95% CI 1.10-2.24, P = .013), and having an ED visit within 12 months before the planned surgery (OR 1.50, 95% CI 1.05-2.14, P = .025) were significantly associated with cancellation. An ED visit within 12 months before planned surgery (OR 2.42, 95% CI 1.27-4.63, P = .008) was associated with a higher risk of not rescheduling after cancellation, whereas Workers' Compensation status trended toward a lower risk of not rescheduling (OR 0.28, 95% CI 0.08-1.06, P = .06). DISCUSSION: Identification of the independent factors associated with cancellation of shoulder arthroscopy may help direct finite health care resources toward intervening among those patients with a high likelihood of rescheduling. LEVEL OF EVIDENCE: Level III (Prognostic).