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

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.

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.

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).

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.