Analysis of Reasons for the Cancellation of Elective Orthopedic Surgeries for Knee or Hip Arthroplasty in Patients Aged 75 and Older: Retrospective Study

Vollständiger Abstract

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INTRODUCTION : Surgical treatment in patients aged 75 years and older is associated with a high risk of intraand postoperative complications, leading to a significant number of cancellations of planned procedures. The cancellation of elective surgeries in elderly patients is a complex medical and organizational issue that has a negative impact on patients, medical institutions, and healthcare systems. OBJECTIVE : The aim of this study is to conduct a retrospective analysis of the reasons for cancellations of elective orthopaedic surgeries in patients 75 or older. MATERIALS AND METHODS : We analyzed the medical records of 109 patients scheduled for knee or hip arthroplasty in 2024. We reviewed the reasons for surgery cancellations in this cohort. RESULTS : Of the 109 planned surgeries in patients aged 75 and older, 55 (51%) were performed. Among the reasons for cancellations, clinical factors predominated, driven by high comorbidity: coronary artery disease, anemia, obesity, atrial fibrillation, oncological diseases, and other concomitant conditions. In some cases, the decision to cancel the surgery was related to the success of conservative therapy or a recent acute respiratory infection. Organizational reasons, primarily long waiting times, as well as episodes with unclear circumstances, also accounted for a significant proportion. Medico-social factors were represented by patient refusal due to fear of surgical intervention, or the inability to provide postoperative care. During follow-up, about half of the previously cancelled interventions were subsequently performed; however, a significant portion remained unrealized. CONCLUSIONS : Every second planned surgical intervention for patients aged 75 years and older was canceled. The key risk factors for cancellation include comorbidities as well as organizational barriers. It is necessary to conduct a comprehensive geriatric assessment in order to optimize preoperative patient preparation and minimize risks, as well as improve patient flow in elective surgery.