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Decision regret and functional recovery after surgery in patients living with frailty

Marr, Catherine, Humphry, Nia, Coakley, Margaret and Goodison, Sarah 2025. Decision regret and functional recovery after surgery in patients living with frailty. Age and Ageing 54 (S3) , afaf254.005. 10.1093/ageing/afaf254.005

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License URL: https://academic.oup.com/pages/standard-publication-reuse-rights
License Start date: 1 October 2025

Abstract

Introduction Patients living with frailty have increased perioperative morbidity and express a four-fold increase in decisional regret following surgery. Effective risk assessment via Comprehensive Geriatric Assessment (CGA) enables informed, shared decision making to reduce regret and optimise functional recovery. Methods 30 patients who were a minimum of 90 days post-op were identified from the Perioperative care of Older People undergoing Surgery (POPS) clinic database. 15/30 patients responded when contacted by telephone. Patients’ decisional regret (The Decision Regret Scale) and functional status (Barthel and Katz measures of Activities of Daily Living (ADLs)) were objectively measured. Pre-op and post-op functional status were compared to evaluate functional recovery. This was a service improvement project, therefore ethical approval was not required. Results Median age 82 (range 71–96); median clinical frailty scale score (CFS) 6; (range 4–6); median length of stay 3 days (range 0–72 days). 6/15 patients demonstrated a decrease in functional status—6/6 detected by Barthel, 5/6 detected by Katz. 2/6 had undergone low risk surgery and 4/6 intermediate risk. 9/15 patients expressed decision regret, 6 of whom also demonstrated a decrease in functional status. 2/9 patients expressed >50% overall decision regret. Conclusions Shared decision making via CGA does not eliminate decision regret. Regret levels in this cohort align with previous literature findings that 1:7 express decision regret following surgery. The Barthel index exhibited more sensitivity to change in ADLs than the Katz tool. Declining functional status and decision regret appear to be linked but do not seem to be directly associated with higher levels of surgical risk.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Schools > Medicine
Additional Information: License information from Publisher: LICENSE 1: URL: https://academic.oup.com/pages/standard-publication-reuse-rights, Start Date: 2025-10-01
Publisher: Oxford University Press
ISSN: 0002-0729
Last Modified: 27 Oct 2025 14:37
URI: https://orca.cardiff.ac.uk/id/eprint/181927

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