Reducing Pediatric MRI Cancellations Through Early Anesthesia Assessment: A Retrospective Analysis at a Tertiary Care...

The use of magnetic resonance imaging (MRI) under anesthesia or moderate sedation has grown in the pediatric age group. Many radiology departments have scheduling problems for pediatric MRIs, as well as on-site cancellations and delays. A contributing factor could be due to the common practice of scheduling pediatric patients for MRIs at the last minute without first consulting with an anesthesiologist. The literature has relatively little information regarding the causes of cancellation of pediatric MRI performed under anesthesia. We predicted that early anesthetic assessment of children might reduce cancellations.

This study aimed to evaluate the relationship between the reduction of MRI cancellations and the early anesthetic assessment conducted ≥48 hours prior to the MRI.

This is a retrospective case-control study reviewing MRI cancellations in a tertiary-level specialized children's hospital during the period from March 2017 to December 2018. All pediatric patients who underwent MRI under general anesthesia during this period were included for analysis. The sample population was restricted to patients under 14 years old. MRI cases that were cancelled were compared as a case group with MRI cases that were not cancelled as a control group regarding anesthesia assessment, type, demographics, MRI study characteristics, and medical factors.

The study included a total of 258 children, with 38 cases and 220 controls. The median age of the patients was 52 months with an IQR of 46.5 months for the case cohort and 58 months with an IQR of 48 months for the control cohort. Statistical analysis of the data indicates that preanesthetic assessment two days or more prior to the MRI reduces the risk of cancellations when compared to other risk factors (P=0.020, CI: 0.69-1.652).

Preanesthetic evaluations can reduce MRI rescheduling appointments, additional diagnostic tests, and potential delays in patient care. Operational efficiency can also be improved, along with patient safety and satisfaction. Thus, preanesthetic assessment is vital to reducing MRI cancellations and improving the efficiency of MRI services.