An audit of the Day-of-Surgery Cancellation of Scheduled Surgical Procedures in Sagamu, Nigeria

Background: Timely performance of scheduled surgical procedures may be an indirect method of assessing the quality of surgical services in a hospital.Objective: This study aimed to determine the rate and the reasons for day-of-surgery cancellation of elective surgical procedures.Methods: A prospective study was conducted at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria to audit the type of surgery and the reasons for the cancellation of procedure among patients scheduled for elective surgical procedures.Results: A total of 1,324 patients were scheduled for elective surgeries during the period of audit and 268 (20.2%) were cancelled on the day of surgery. One hundred and seventy-four of the 268 (65.0%) cancellations were avoidable while 94 (35.0%) cancellations were unavoidable. The reasons for the cancellation of surgeries included patient-related factors (35.0%), unfavourable pre-operative clinical evaluation (31.0%), facility-based factors (28.0%) and surgeon-related factors (6.7%).Conclusion: The day-of-surgery cancellation rate was 20.2%, and the three leading causes of cancellation of elective surgeries in Sagamu included patient-related factors, unfavourable pre-operative clinical evaluation and inadequacies of hospital resources

Trends in the clinical Pattern, diagnosis and management of rhinosinusitis in a sub-urban tertiary health centre

Background: Rhinosinusitis (RSS) is a common form of upper airway disease encountered by Otolaryngologists. Objectives: To describe the trends in the clinical presentation, diagnosis and management of RSS in a tertiary hospital.Methods:Retrospective analysis of clinical information retrieved from the hospital records of patients with RSS managed in the ENT department of OOUTH Sagamu over an 18-month period was done.Results: Out of 1814 patients, 143 had RRS with the prevalence rate of 7.9%. The male-to-female ratio was 1.1:1, the age ranged from 7 to 79 (median = 32.4) years. The presenting symptoms included mucoid nasal discharge (68.7%), nasal congestion (61.5%) and excessive sneezing (46.8%). Most (71.3%) of the patients presented after 3weeks of the onset of symptoms and the median duration was 3.2 months. The leading physical findings included engorged nasal turbinates (78.3%), ooedematous nasal mucosa (72.0%), mucopurulent anterior rhinorrhoea (28.6%) and pale nasal mucosa (25.9%). The investigations done included plain X-Rays of the sinuses (86.0%), full blood count (67.1%) and computerized tomographic (CT) scan of the sinuses (8.4%). Plain X-Ray abnormalities were most common in the maxillary sinuses (45.5%) while 30.1% had multi-sinusitis. The trend of diagnosis ranged from infective RSS in 51.7% to allergic RSS in 38.5%. About a quarter had different forms of non-endoscopic surgical intervention. Recorded complications included nasal polyps in 11.9%. Conclusion: The trend of RSS observed relative affectation of adults and mostly chronic infective types, and sometimes allergic types.Radiological assessment was by plain X-Rays in most cases, management was either medical or non-endoscopic surgical methods, frequently complicated by polyps