Journal of Surgical Research
Volume 151, Issue 1 , Pages 6-9, January 2009

Brief Report: Do Patients With Poor Outcomes Regret Having Had Infrainguinal Bypass Surgery?1

  • Margaret L. Schwarze, M.D., M.P.P.

      Affiliations

    • Department of Surgery, University of Wisconsin, Madison, Wisconsin
    • MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois
    • Corresponding Author InformationTo whom correspondence and reprint requests should be addressed at Division of General Surgery, University of Wisconsin, G5/315 CSC, 600 Highland Ave., Madison, WI 53792
    • ,
  • Maliha A. Sayla, B.A.

      Affiliations

    • University of Chicago, Chicago, Illinois
    • ,
  • G. Caleb Alexander, M.D., M.S.

      Affiliations

    • MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois
    • Robert Wood Johnson Clinical Scholars Program, University of Chicago, Chicago, Illinois
    • Department of Medicine, University of Chicago Hospitals, Chicago, Illinois

Received 14 March 2007 published online 30 June 2007.

Background

Retrospection and hindsight bias may lead patients with bad outcomes to regret the choice of infrainguinal bypass surgery.

Objective

To assess patients' retrospective evaluations of surgery stratified by common criteria to judge surgical success.

Survey Design

Cross-sectional phone surveys of 33 patients, an average of 162 d following infrainguinal bypass surgery.

Results

Of the 33 patients evaluated, 26 (79%) experienced undesirable outcomes, including amputation (4, 12%), prolonged hospitalization (8, 24%), wound infection (8, 24%), readmission to the hospital (12, 36%), additional surgery (11, 33%), and other complications (16, 48%). Of the patients surveyed, nearly all (30, 91%) reported that they would still want to have had the surgery if they had a 5-y 50% mortality, and the same proportion reported they would recommend the surgery to someone else with similar medical problems (30, 91%).

Conclusions

If confirmed in larger populations, these findings suggest that when viewed retrospectively, results traditionally considered poor outcomes may not deter many patients' preferences for surgical management of their infrainguinal vascular disease.

Key Words: limb salvage, infrainguinal bypass, surgical ethics, hindsight bias

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 
  • 1 This work was presented as a poster at the Society for General Internal Medicine Midwest Regional Meeting, Chicago, IL, September 2005.

PII: S0022-4804(07)00371-X

doi:10.1016/j.jss.2007.05.019

Journal of Surgical Research
Volume 151, Issue 1 , Pages 6-9, January 2009

Article Tools

* Image Usage & Resolution