Evidence map›Paper›PMID 41823967›Full record

ArticleJAMA network open2026

Recovery Experiences of Older Adults and Their Caregivers After Major Elective Noncardiac Surgery.

Nelly Toledano, Nicholas Legacy, Duminda N Wijeysundera, Nai-Wen Ku, Kristen R Haase, Eric Pitters, Fay Bennie, Anne Stephens, Gianni R Lorello, Kerry Kuluski and 21 more

Abstract readMulticenter Study
In one paragraph

Article in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors.

Nelly ToledanoLawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Nicholas LegacyLawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Duminda N WijeysunderaDepartment of Anesthesia, St Michael's Hospital-Unity Health Toronto, Toronto, Ontario, Canada.
Nai-Wen KuLawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Kristen R HaaseSchool of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada.
Eric PittersPatient partner.
Fay BennieOlder adult team member.
Anne StephensFamily caregiver team member.
Gianni R LorelloDepartment of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.
Kerry KuluskiInstitute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada.
Daniel I McIsaacDepartment of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
Tyler R ChesneyDepartment of General Surgery, St Michael's Hospital-Unity Health Toronto, Toronto, Ontario, Canada.
Keying XuApplied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital-Unity Health Toronto, Toronto, Ontario, Canada.
Naveed SiddiquiDepartment of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.
Karim S LadhaDepartment of Anesthesia, St Michael's Hospital-Unity Health Toronto, Toronto, Ontario, Canada.
C David MazerDepartment of Anesthesia, St Michael's Hospital-Unity Health Toronto, Toronto, Ontario, Canada.
Noah CramptonDepartment of Family Medicine, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Stuart A McCluskeyDepartment of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.
Matteo ParottoDepartment of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.
Lisa Del GiudiceDepartment of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Angela JerathDepartment of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.
Janet van VlymenDepartment of Anesthesiology and Perioperative Medicine, Kingston Health Science Centre, Kingston, Ontario, Canada.
Su-Yin MacDonellDepartment of Anesthesia, St Paul's Hospital, Providence Health Care, Vancouver, British Columbia, Canada.
Melinda DavisDepartment of Anesthesiology, Perioperative and Pain Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
Alexander J GregoryDepartment of Anesthesiology, Perioperative and Pain Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
Eric JacobsohnDepartment of Anesthesiology, Pain and Perioperative Medicine, Winnipeg Health Sciences Centre, Winnipeg, Manitoba, Canada.
David B MacDonaldDepartment of Anesthesia, Pain Management and Perioperative Medicine, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
Katherine S McGiltonLawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Emily HladkowiczAcute Care Research Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Shabbir M H AlibhaiDepartment of Medicine, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Martine PutsLawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: An increasing number of older adults living with frailty are undergoing surgery, yet scarce data on postoperative functional recovery, care needs after surgery, and extent of caregiver supports exist. Objective: To characterize older adults' and caregivers' recovery experiences in the first 6 months after surgery. Design, Setting, and Participants: This mixed-methods, multicenter, prospective nested cohort study included 17 hospitals in Canada. Participants included adults aged 65 years or older with a Clinical Frailty Scale score of 4 or more, who were recovering after major elective noncardiac surgery between March 16, 2021, and June 13, 2023, and their caregivers. Main Outcomes and Measures: Surveys included functional status via basic and instrumental activities of daily living, care needs, and care received or provided. A subset of patients and caregivers were invited to participate in semistructured interviews about their experiences and were analyzed using interpretive descriptive qualitative analysis. Results: There were 289 individuals, including 204 older adults (mean [SD] age, 72.8 [5.6] years; 108 males [52.9%]) and 85 caregivers (mean [SD] age, 68.2 [12.2] years; 50 females [59.5%]), who participated in surveys, and 63 individuals (43 older adults and 20 caregivers) who participated in interviews. Older adults had a median (range) Clinical Frailty Score of 4 (3-6), indicating mild frailty, and 190 (93.1%) had 1 or more chronic diseases. Caregivers had a median (range) of 2 (0-8) chronic diseases, and 69 (82%) were spouses. Two months postoperatively, 129 of 203 older adults (64%) had more than 1 instrumental activities of daily living impairment, decreasing to 84 of 198 (42%) at 6 months after surgery; 68 of 203 (33%) had more than 1 activities of daily living impairment 2 months postoperatively, and this decreased to 38 of 198 (19%) at 6 months after surgery. Themes related to the recovery experiences were: (1) inadequate patient and caregiver education, preparation for surgery, and discharge; (2) the association of reduced independence with patient and caregivers; (3) the association of surgery with mental health; and (4) postoperative support from the health care team. All participants indicated that they wanted to be better prepared for surgery and discharge. Conclusion and Relevance: In this mixed-methods cohort study, functional recovery in the first 6 months after noncardiac major elective surgery was associated with daily living impairment for older adults and their caregivers. Targeted interventions including preoperative education, caregiver-inclusive discharge planning (eg, wound-care teaching, how to recognize complications and what to do for support, and more rehabilitation), and early follow-up after discharge may optimize recovery experiences.

Indexed as

CaregiversElective Surgical ProceduresFrail ElderlyRecovery of FunctionActivities of Daily LivingAgedAged, 80 and overCanadaFemaleFrailtyHumansMaleProspective StudiesSurveys and Questionnaires

Identifiers

PMID41823967
PMCPMC12988445

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.