Decisional Regret Among Older Adults Undergoing Corrective Surgery for Adult Spinal Deformity: A Single Institutional Study.
Decisional Regret Among Older Adults Undergoing Corrective Surgery for Adult Spinal Deformity: A Single Institutional Study.
复制标题
接受成人脊柱畸形矫正手术的老年人的决定性遗憾：一项单一机构研究。
DOI：
10.1097/brs.0000000000004287
复制
发表时间：
2022
期刊：
影响因子：
3
通讯作者：
Makris,Una
中科院分区：
文献类型：
--
作者：
Adogwa,Owoicho;Caruso,JamesP;Eldridge,CodyM;Singh,Ravinderjit;Chilakapati,Sai;Deme,Palvasha;Stutzman,Sonja;Aoun,SalahG;Naik,AanandD;Bagley,CarlosA;Makris,Una
研究设计：回顾性目的：调查因成人脊柱畸形（ASD）接受手术的老年人中决策后悔的发生率。背景资料概要：在老年人（≥ 65岁）中，ASD是残疾的主要原因，人群患病率为60%-70%。虽然手术是有益的，并在功能改善的结果，在超过20%的老年人的结果从surgery is less desirable.Methods.老年人ASD谁接受了脊柱手术在四级医疗中心从2016年1月1日至2019年3月1日，被纳入本研究。根据患者对渥太华决策后悔问卷的回答，将其分为中/高或低决策后悔队列。在手术后24个月完成了决定性后悔评估。主要结果指标是手术后决策后悔的发生率。结果：共155例患者（平均年龄69.5岁）符合研究纳入标准。总体而言，80%的人认为手术是正确的决定，77%的人将来会做出同样的选择。共有21%的人后悔他们所做的选择，21%的人回答说手术对他们造成了伤害。比较报告中/高与低决策后悔的患者队列，在基线人口统计学、合并症、手术侵入性、住院时间、出院处置或术后12个月功能改善程度方面没有差异。在调整性别、美国麻醉医师协会评分、手术侵入性和术后并发症后，术前抑郁的老年人高决策后悔的几率增加了4.0倍（P= 0.04）。在12个月后surgery.Conclusion.，虽然大多数老年人得到了适当的咨询，并对他们的决定感到满意，但五分之一的老年人后悔他们接受手术的决定。术前抑郁与多变量analysis.Level of Evidence中/高决策后悔相关：4虽然ASD的手术是有益的，并导致功能改善，但在超过20%的老年人中，手术的结果不太理想。80%的患者认为手术是正确的决定，77%的患者将来会做出同样的选择，21%的患者后悔自己的选择。
Study Design.Retrospective.Objective.To investigate the prevalence of decisional regret among older adults undergoing surgery for adult spinal deformity (ASD).Summary of Background Data.Among older adults (≥ 65 years old), ASD is a leading cause of disability, with a population prevalence of 60% to 70%. While surgery is beneficial and results in functional improvement, in over 20% of older adults outcomes from surgery are less desirable.Methods.Older adults with ASD who underwent spinal surgery at a quaternary medical center from January 1, 2016 to March 1, 2019, were enrolled in this study. Patients were categorized into medium/high or low-decisional regret cohorts based on their responses to the Ottawa decision regret questionnaire. Decisional regret assessments were completed 24 months after surgery. The primary outcome measure was prevalence of decisional regret after surgery. Factors associated with high decisional regret were analyzed by multivariate logistic regression.Results.A total of 155 patients (mean age, 69.5 yrs) met the study inclusion criteria. Overall, 80% agreed that having surgery was the right decision for them, and 77% would make the same choice in future. A total of 21% regretted the choice that they made, and 21% responded that surgery caused them harm. Comparing patient cohorts reporting medium/high-versus low-decisional regret, there were no differences in baseline demographics, comorbidities, invasiveness of surgery, length of stay, discharge disposition, or extent of functional improvement 12-months after surgery. After adjusting for sex, American Society of Anesthesiologists score, invasiveness of surgery, and presence of a postoperative complication, older adults with preoperative depression had a 4.0 fold increased odds of high-decisional regret (P= 0.04). Change in health related quality of life measures were similar between all groups at 12-months after surgery.Conclusion.While the majority of older adults were appropriately counseled and satisfied with their decision, one-in-five older adults regret their decision to undergo surgery. Preoperative depression was associated with medium/high decisional regret on multivariate analysis.Level of Evidence: 4While surgery for ASD is beneficial and results in functional improvement, in over 20% of older adults outcomes from surgery are less desirable. 80% of patients agreed that having surgery was the right decision for them, 77% would make the same choice in future, and 21% regretted their choice.
登录
查看更多内容
瑞士沃州贲门和远端胃腺癌的描述性流行病学
影响因子：
1.9
作者：
F. Levi;C. la Vecchia;V. Te
通讯作者：
V. Te
Ohkawara，S；Goto，F；Yoshinaga，M：Acta Pathol Jpn。
DOI：
--
发表时间：
--
期刊：
影响因子：
--
作者：
通讯作者：
--
洛杉矶县年轻男性的生活方式、工作场所和胃癌的分部位。
影响因子：
11.2
作者：
Wu-Williams,AH;Yu,MC;Mack,TM
通讯作者：
Mack,TM
影响因子：
--
作者：
F. Fidanza;N. Versiglioni
通讯作者：
N. Versiglioni
食物的成分
DOI：
--
发表时间：
1946
期刊：
影响因子：
--
作者：
R. Mccance;E. Widdowson
通讯作者：
E. Widdowson