title: Patient function and caregiver burden after ambulatory surgery: a cohort study of patients older than 65.
abstract: OBJECTIVE
  The primary objective of this prospective cohort study was to assess the impact of ambulatory surgery on patient function one week and one month following surgery among surgical patients ≥ 65 yr of age. Secondary objectives were to determine whether changes in patient function were correlated with increased burden of care in the patient's primary caregiver and with patient assessments of postoperative pain and quality of life.
  
  
  METHODS
  Following Research Ethics Board approval, patients aged ≥ 65 yr undergoing elective ambulatory surgery and their caregivers were recruited. Patients completed the système de mesure de l'autonomie fonctionnelle (SMAF) and the Brief Pain Inventory. Primary caregivers completed the Zarit Burden Interview (ZBI). All measurements were obtained preoperatively and on postoperative days (POD) 7 and 30.
  
  
  RESULTS
  Patient function decreased on POD 7 and had not returned to baseline on POD 30 (mean change in SMAF 6.9; 95% confidence interval (CI) 5.3 to 8.4 on POD 7 and mean change in SMAF 2.6; 95% CI 1.3 to 4.0 on POD 30). Interval changes in caregiver burden were not significant (mean change in ZBI -0.4; 95% CI -1.8 to 0.96 on POD 7 and mean change in ZBI -0.6; 95% CI -2.1 to 0.8 on POD 30). Decreased patient function was associated with increased caregiver burden at all time points (P < 0.001). Decreased caregiver function at baseline was also associated with higher ZBI (linear association 0.71; P = 0.02).
  
  
  CONCLUSIONS
  Patients exhibited reduced function seven days following ambulatory surgery. Patient function largely recovered by POD 30. Caregiver burden was variable and influenced by both patient and caregiver function. This trial was registered with Clinical Trials.gov (NCT01382251).
authors.affiliation: Department of Anesthesiology, The Ottawa Hospital, 1053 Carling Avenue, Box 249C, Ottawa, ON, K1Y 4E9, Canada. glbryson@ottawahospital.on.ca
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Bryson
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Clavel
authors.forename: Rebecca
authors.initials: R
authors.lastname: Moga
authors.forename: Barbara
authors.initials: B
authors.lastname: Power
authors.forename: Monica
authors.initials: M
authors.lastname: Taljaard
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Nathan
mesh_terms: D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000534:rehabilitation*; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology*; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D013997:Time Factors