What are parents willing to accept? A prospective study of risk tolerance in AIS surgery
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What are parents willing to accept? A prospective study of risk tolerance in AIS surgery Baron Lonner1 · Amit Jain2 · Paul Sponseller2 · Lily Eaker1 · Amer Samdani3 · Michael Kelly4 · Andrea Castillo1 · Majd Marrache2 · Christopher P. Ames5 · Suken A. Shah6 · Harms Study Group Investigators Received: 21 July 2020 / Accepted: 21 September 2020 © Scoliosis Research Society 2020
Abstract Introduction Surgical treatment of Adolescent Idiopathic Scoliosis (AIS) involves healthy individuals with spinal deformity. Parents are responsible for surgical consent on behalf of their children, a burden which causes trepidation and concern. Therefore, explanation of operative risk is a critical component of informed consent and parent decision-making. We set out to quantify parental risk aversion (RA). Methods RA questionnaires were administered preoperatively to parents of 58 AIS patients undergoing spinal fusion (SF). RA is the likelihood of a parent to consent to their child’s SF (1- least likely, 10- most) with increasing allotments of data about potential complications at each stage (S1-complication named, S2-explained, S3-incidence given, S4-all information). A statistically significant mean difference in answers for each stage was assessed using paired sample t test or Wilcoxon rank t test. Normality was assessed by performing Shapiro–Wilk test. Results AIS patients (age 14.2 years, 85% female, major curve 61°) were included. Mean scores for each of the stages were 4.4 ± 3.1, 4.9 ± 3.1, 6.5 ± 3.0, 6.6 ± 3.0, respectively. Highest and lowest RA were reported for death and infection, respectively. The greatest increase in likelihood to proceed with surgery was seen after education on malposition of implants and on death, 2.6 and 2.5, respectively (p
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