P75. Psychological distress does not predict decisional regret in adult spinal deformity

BACKGROUND CONTEXT Recent literature has suggested that 20% of patients had moderate to high regret following adult spinal deformity surgery. Despite psychological comorbidity being increasingly recognized to influence patient-reported outcomes, its effects on patient decision-making and regret have yet to be determined. We hypothesize that patients with high psychological comorbidity have greater regret following adult spinal deformity reconstruction surgery. PURPOSE This study aims to assess the relationship between psychological distress stratification and decisional regret following adult spinal deformity surgery. STUDY DESIGN/SETTING Prospective single-center consecutive case series. PATIENT SAMPLE Patients included were part of a prospectively maintained database of spinal deformities operated at our institution. Patients operated between January 1, 2014 to May 1, 2020, were included. All patients had a minimum of 2-year postop followup. All patients were stratified by a preoperative psychological distress assessment as previously described by our institution. OUTCOME MEASURES Decisional regret was evaluated using the Decision Regret Scale and question 22 of the SRS-22 questionnaire. METHODS A single-center consecutive case series of patients operated on for ASD was performed. We used logistic regression for our main hypothesis tests. RESULTS A total of 112 patients (66.7%) who were eligible and responded to the surveys were analyzed. There was no significant difference among the psychological distress groups based on age, gender and ASA; 41% of patients were not regretful based on the Decision Regret Scale; 63% of patients were not regretful based on the Single-Item scale of the SRS-22 questionnaire. No significant main effects for any predictors were observed. CONCLUSIONS The result of this work suggests that psychological distress grading did not predict decisional regret levels in patients with at least a 2-year followup following adult spinal deformity surgery. Approximately 40% of patients may show some degree of regret. This study contributes to further understanding of the factors associated with decisional regret in spinal deformity surgery. Understanding the factors involved in regret is key as this opens a new dimension for evaluating patient-reported outcomes. FDA Device/Drug Status This abstract does not discuss or include any applicable devices or drugs. Recent literature has suggested that 20% of patients had moderate to high regret following adult spinal deformity surgery. Despite psychological comorbidity being increasingly recognized to influence patient-reported outcomes, its effects on patient decision-making and regret have yet to be determined. We hypothesize that patients with high psychological comorbidity have greater regret following adult spinal deformity reconstruction surgery. This study aims to assess the relationship between psychological distress stratification and decisional regret following adult spinal deformity surgery. Prospective single-center consecutive case series. Patients included were part of a prospectively maintained database of spinal deformities operated at our institution. Patients operated between January 1, 2014 to May 1, 2020, were included. All patients had a minimum of 2-year postop followup. All patients were stratified by a preoperative psychological distress assessment as previously described by our institution. Decisional regret was evaluated using the Decision Regret Scale and question 22 of the SRS-22 questionnaire. A single-center consecutive case series of patients operated on for ASD was performed. We used logistic regression for our main hypothesis tests. A total of 112 patients (66.7%) who were eligible and responded to the surveys were analyzed. There was no significant difference among the psychological distress groups based on age, gender and ASA; 41% of patients were not regretful based on the Decision Regret Scale; 63% of patients were not regretful based on the Single-Item scale of the SRS-22 questionnaire. No significant main effects for any predictors were observed. The result of this work suggests that psychological distress grading did not predict decisional regret levels in patients with at least a 2-year followup following adult spinal deformity surgery. Approximately 40% of patients may show some degree of regret. This study contributes to further understanding of the factors associated with decisional regret in spinal deformity surgery. Understanding the factors involved in regret is key as this opens a new dimension for evaluating patient-reported outcomes.