SP 5.05 Who Reports Surgical Complications Better: Patients or Clinicians? Early Findings from the Patient-Reported Complications Study

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ID: 323980
2026
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Abstract
Abstract Aims Informed consent depends on patients understanding surgical risks, yet reliable data on postoperative complications remains limited. This study assessed whether patients, supported by their digital consent documentation, can reliably report postoperative complications and whether their reports agree with clinician documentation. Methods This study received Research Ethics Committee approval (IRAS326998). Patients undergoing wide local excision with sentinel lymph node biopsy who provided digital consent were recruited from a single breast unit over 12 months (April 2024-April 2025; n=159). At four weeks post-surgery, patients completed a complications questionnaire aligned with their digital consent documentation. Patient-reported complications (PRCs) were compared with clinician-reported complications (CRCs) from medical records. Agreement between PRCs and CRCs was assessed using percent agreement, positive agreement (PA; agreement when complications were present; 0-1), and Cohen’s kappa (k; chance-corrected agreement; 0-1). Results Patients reported significantly more complications than clinicians (mean 3.9 PRCs vs. 1.0 CRCs per surgery; p<0.0001). Percent agreement ranged from 26%-100%, with lowest agreement for minor complications (bruising, discolouration). Agreement was very good (>0.8/1) for clinically significant complications such as incomplete excision (PA=0.89/1.0, k=0.88/1.0), wound infection (PA=0.82/1.0, k=0.81/1.0), and blue dye reaction (PA=1.0/1.0, k=1.0/1.0), and good (>0.6/1) for haematoma (PA=0.77/1.0, k=0.76/1.0) and seroma (PA=0.68/1.0, k=0.529). Conclusions Patients reported more complications than clinicians, particularly minor events, suggesting clinical under-reporting. Strong agreement on complications requiring clinical intervention suggests reliable patient reporting of clinically significant events. Patient-led complication reporting represents a scalable, patient-centered approach to postoperative complication capture that could supplement current complication data and enhance understanding in consent discussions.
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Authors Amy Huseyin, Isabelle Roach, Lisa Sheehan, Karen Hudson, Avi Agrawal, Edward St John
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.064
URL
https://doi.org/10.1093/bjs/znag087.064
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