Risk Attitude and Preference in Patients Facing Aortic Surgery
Research type
Research Study
Full title
Risk Attitude and Preference in Patients Facing Aortic Surgery
IRAS ID
167175
Contact name
Ian Nordon
Contact email
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Abdominal Aortic Aneurysms [AAAs] have been described as “silent killers” and “ticking time bombs”. They are swollen blood vessels in the abdomen that have potential to burst, often with a fatal outcome. Elective surgery is generally offered to patients when their AAA reaches a diameter greater than 5.5cm; approximately three times the normal size. This threshold size for surgery is based on epidemiological evidence and prospective randomised data from the UK Small Aneurysm Trial. [Filardo G et al. 2012] These demonstrated that at 5.5-6cm the annualised risk of rupture [8%] was greater than the mortality risk associated with open surgery [5%]. This balance of rupture risk versus surgical risk has long directed surgical timing. There is no evidence in the literature as to what level of risk patients find acceptable, or what absolute risk reduction they perceive as appropriate to undergo major surgery. This is especially relevant in aortic surgery as AAAs are often discovered in patients in the eighth decade of life, and surgery has associated morbidity and an inevitable impact on health-related quality of life.
Studies exploring the preferred treatments for AAAs have concluded that mortality risk is the greatest determinant in patient choice of procedure [Faggioli G. et al. 2011]. A hypothetical study exploring attitudes in a healthy population found that subjects over 80 were likely to choose to live with their AAA rather than expose themselves to surgery [Letterstal A. et al. 2012. This study will prospectively explore patients’ preference and attitude to risk when confronted with an AAA warranting treatment.REC name
South Central - Hampshire B Research Ethics Committee
REC reference
14/SC/1440
Date of REC Opinion
5 Feb 2015
REC opinion
Further Information Favourable Opinion