Caregiver Burden and Its Effect on Postoperative Outcomes in the Older Surgical Patient

Purpose: As the United States population continues to age, it will place greater demands on surgical services. Nurses are challenged by the perioperative management of the older surgical patient as well as the needs of those family/significant others providing care for these patients. The goal of the study was to better understand the relationship between caregiver burden and the postoperative outcomes of the older surgical patient.

Methods:  Retrospective case review study of 209 older surgical patients (age 75 years and older) that underwent a geriatric preoperative assessment per the 2012 ACS NSQIP/AGS Best Practice Guidelines: Optimal Preoperative Assessment of the Geriatric Surgical Patient prior to an elective surgical intervention. Complications as defined by NSQIP standards were recorded as well as length of stay, rate of readmission and mortality. The Zarit Caregiver Burden Interview tool was completed by an individual that identified themselves as a caregiver when the patient was seen for preoperative evaluation. Statistical analysis identified correlations between increasing caregiver burden and those postoperative NSQIP complications identified in the study.

Results:  In those patients with significant caregiver burden recorded preoperatively, several statistical correlations were identified including greater rates of unplanned intubation, development of deep vein thrombi, and development of postoperative acute renal injury. Patients whose caregiver burden score was elevated also experienced greater rates of mortality when compared to the general older surgical population.

Conclusion: This information helps assess physiological, psychological and social factors that may influence postoperative patient recovery in the older surgical population. Recognition of caregiver burden may allow early intervention and influence both patient and caregiver outcomes.