Informed consent for emergency surgery--how much do parents truly remember?

The purpose of this study was to evaluate parental retention of possible surgical complications in children undergoing emergency laparoscopic appendectomy.

A prospective pilot study involving parents whose children had emergency laparoscopic appendectomy was performed. Parents were counseled regarding 7 potential complications of laparoscopic appendectomy. They were asked to recall this list immediately after the consent process (immediate recall, IR) and before discharge from inpatient stay (delayed recall, DR). A score (0-7) was awarded indicating the number of correct answers. For each recall, parents were also reminded on complications they omitted (prompted recall). One surgeon administered all consents in person. Demographic data were collected. Data were reported as median (range).

Twenty-one mothers and 10 fathers were recruited, aged 42 years (30-54). Nine (29%) had university or post-graduate education. Score for IR was 2 (0-6). Five (16%) parents scored 0. Upon prompting after IR, 20 (65%) parents had no impression of at least 1 complication. Score for DR was 2 (0-7), while 7 (23%) parents scored 0. At prompting after DR, 25 (81%) had no memory of at least one complication. Eight (26%) demonstrated improved DR scores. Scores were not affected by patient demographics or time between interviews.

There is poor parental retention of information provided during operative consent. Hence, proper documentation of this process is essential.