Decisional regret following corrective adult spinal deformity surgery: a single institution study of incidence and risk factors.

Autor: Du JY; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA. jerry.y.du@gmail.com., Lovecchio FC; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA., Kazarian G; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA., Clohisy J; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA., Pajak A; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA., Kaidi A; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA., Knopp R; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA., Akosman I; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA., Johnson M; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA., Nakarai H; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA., Dash A; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA., Samuel JT; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA., Cunningham ME; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA., Kim HJ; Hospital for Special Surgery, New York City, NY, 535 E 70th St.10021, USA.
Jazyk: angličtina
Zdroj: Spine deformity [Spine Deform] 2024 May; Vol. 12 (3), pp. 775-783. Date of Electronic Publication: 2024 Jan 30.
DOI: 10.1007/s43390-023-00790-y
Abstrakt: Purpose: To assess the characteristics and risk factors for decisional regret following corrective adult spinal deformity (ASD) surgery at our hospital.
Methods: This is a retrospective cohort study of a single-surgeon ASD database. Adult patients (> 40 years) who underwent ASD surgery from May 2016 to December 2020 with minimum 2-year follow-up were included (posterior-only, ≥ 4 levels fused to the pelvis) (n = 120). Ottawa decision regret questionnaires, a validated and reliable 5-item Likert scale, were sent to patients postoperatively. Regret scores were defined as (1) low regret: 0-39 (2) medium to high regret: 40-100. Risk factors for medium or high decisional regret were identified using multivariate models.
Results: Ninety patients were successfully contacted and 77 patients consented to participate. Nonparticipants were older, had a higher incidence of anxiety, and higher ASA class. There were 7 patients that reported medium or high decisional regret (9%). Ninety percentage of patients believed that surgery was the right decision, 86% believed that surgery was a wise choice, and 87% would do it again. 8% of patients regretted the surgery and 14% believed that surgery did them harm. 88% of patients felt better after surgery. On multivariate analysis, revision fusion surgery was independently associated with an increased risk of medium or high decisional regret (adjusted odds ratio: 6.000, 95% confidence interval: 1.074-33.534, p = 0.041).
Conclusions: At our institution, we found a 9% incidence of decisional regret. Revision fusion was associated with increased decisional regret. Estimates for decisional regret should be based on single-institution experiences given differences in patient populations.
(© 2024. The Author(s), under exclusive licence to Scoliosis Research Society.)
Databáze: MEDLINE
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