Assessing surgeons' disclosure of risk information before carotid endarterectomy

ANZ J Surg. 2006 Jul;76(7):618-24. doi: 10.1111/j.1445-2197.2006.03788.x.


Background: To make an informed decision about treatment, patients need accurate information about the benefits and risks of treatment and 'non-treatment' options. A survey was conducted to determine patients' recall of the extent and effect of preoperative disclosure by surgeons to patients of risks about carotid endarterectomy (CEA).

Methods: A self-administered questionnaire was given to 133 patients undergoing elective CEA in New South Wales. The primary outcome measures were patient recall of preoperative discussion, self-assessed estimates of stroke risk with and without surgery and receipt of written information before CEA.

Results: A significantly higher proportion of patients recalled that their surgeon discussed the short-term stroke risk (i.e. within 30 days) if they decided to undergo CEA (86.2%) than if they decided not to have the procedure (76.9%) (P = 0.04). Of those patients who recalled the surgeon discussing their short-term stroke risk with CEA, only 24 (18.0%) were accurately able to quantify this risk. Patients were significantly more likely to recall their surgeon discussing their long-term stroke risk (i.e. within 2 years) if they decided not to have CEA (72.4%) than if they decided to have the CEA (31.5%) (P < 0.0001).

Conclusions: Patients recalled discussions with their surgeon about short-term stroke risk. Only a minority, however, accurately quantified their postoperative stroke risk. In view of variable patient recall, decision aids could assist.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carotid Artery Diseases / complications
  • Carotid Artery Diseases / surgery
  • Clinical Competence
  • Decision Making*
  • Endarterectomy, Carotid / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • New South Wales / epidemiology
  • Patient Education as Topic
  • Risk Factors
  • Stroke / epidemiology
  • Stroke / etiology
  • Surveys and Questionnaires
  • Treatment Outcome
  • Truth Disclosure*