What do patients recall from informed consent given before orthopedic surgery?

Abstract

Objectives: We aimed to evaluate the effectiveness of the consent process and the retention of relevant information in patients with orthopedic trauma and those undergoing elective surgery.

Methods: The study enrolled 142 consecutive patients (79 women, 63 men; mean age 52.02 +/- 20.05 years) undergoing either elective or trauma-related surgery. The patients were introduced to the consent process, which involves a verbal and written explanation of the orthopedic condition, surgical procedure, and intraoperative and postoperative risks. At postoperative 1-3 days, patients were asked to recall the orthopedic condition, procedure they underwent, and risks of the surgery.

Results: The rate of recall by patients was 131/142 patients (92.3%) for diagnosis, 86/142 patients (60.6%) for surgical procedure, and 32/142 patients (22.5%) for potential complications. Fifty-nine patients (41.5%) could not recall any potential complications. Gender did not influence the ability to describe the operation or potential complications (p > 0.05). Advanced age negatively affected recall of information about the surgery and complications (p < 0.01), and educational level was correlated with the recall rate (p < 0.05). Forty-two patients (29.6%) claimed to have read the consent form before signing it. A greater percentage of patients undergoing elective surgery had read the consent form (p < 0.05). Rate of not recalling any potential complications was higher in the trauma group compared with the elective surgery group (p < 0.01).

Conclusion: Patients had poor retention of information presented during the consent procedure. Further attention should be focused on enhancing patients understanding of several components of the informed consent process for surgery.