A systematic review of comprehensive geriatric assessment to improve outcomes for frail older people being rapidly discharged from acute hospital: 'interface geriatrics'

被引:114
作者
Conroy, Simon Paul [1 ]
Stevens, Tony [2 ]
Parker, Stuart G. [3 ]
Gladman, John R. F. [2 ]
机构
[1] Univ Leicester, Leicester Royal Infirm, Sch Med, Leicester LE2 7LX, Leics, England
[2] Univ Nottingham, Sch Med, Queens Med Ctr, Div Rehabil & Ageing,Sch Community Hlth Sci, Nottingham NG7 2UH, England
[3] Sheffield Inst Studies Ageing, Community Sci Ctr, Sheffield S7 5AU, S Yorkshire, England
关键词
acute care; comprehensive geriatric assessment; frailty; randomised controlled trial; systematic review; elderly; EMERGENCY-DEPARTMENT; ELDERLY-PEOPLE; INTERVENTION; HOME; TRIAL; UNITS; FALLS; CARE;
D O I
10.1093/ageing/afr060
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
030301 [社会学]; 100201 [内科学];
摘要
Methods: standard bibliographic databases were searched for high-quality randomised controlled trials (RCTs) of CGA in this setting. When appropriate, intervention effects were presented as rate ratios with 95% confidence intervals. Results: five trials of sufficient quality were included. There was no clear evidence of benefit for CGA interventions in this population in terms of mortality [RR 0.92 (95% CI 0.55-1.52)] or readmissions [RR 0.95 (95% CI 0.83-1.08)] or for subsequent institutionalisation, functional ability, quality-of-life or cognition. Conclusions: there is no clear evidence of benefit for CGA interventions in frail older people being discharged from emergency departments or acute medical units. However, few such trials have been carried out and their overall quality was poor. Further well designed trials are justified.
引用
收藏
页码:436 / 443
页数:8
相关论文
共 24 条
[1]
ALI W, 2004, WHAT IS EVIDENCE EFF, V7
[2]
[Anonymous], EVALUATION CONSULTAN
[3]
[Anonymous], 1991, J AM GERIATR SOC
[4]
Effectiveness of acute geriatric units on functional decline, living at home, and case fatality among older patients admitted to hospital for acute medical disorders: meta-analysis [J].
Baztan, Juan J. ;
Suarez-Garcia, Francisco M. ;
Lopez-Arrieta, Jesus ;
Rodriguez-Manas, Leocadio ;
Rodriguez-Artalejo, Fernando .
BMJ-BRITISH MEDICAL JOURNAL, 2009, 338 :334-336
[5]
Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis [J].
Beswick, Andrew D. ;
Rees, Karen ;
Dieppe, Paul ;
Ayis, Salma ;
Gooberman-Hill, Rachael ;
Horwood, Jeremy ;
Ebrahim, Shah .
LANCET, 2008, 371 (9614) :725-735
[6]
Hospital in the home: a randomised controlled trial [J].
Caplan, GA ;
Ward, JA ;
Brennan, NJ ;
Coconis, J ;
Board, N ;
Brown, A .
MEDICAL JOURNAL OF AUSTRALIA, 1999, 170 (04) :156-160
[7]
A randomized, controlled trial of comprehensive geriatric assessment and multidisciplinary intervention after discharge of elderly from the emergency department - The DEED II study [J].
Caplan, GA ;
Williams, AJ ;
Daly, B ;
Abraham, K .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2004, 52 (09) :1417-1423
[8]
Prevention of falls in the elderly trial (PROFET): a randomised controlled trial [J].
Close, J ;
Ellis, M ;
Hooper, R ;
Glucksman, E ;
Jackson, S ;
Swift, C .
LANCET, 1999, 353 (9147) :93-97
[9]
Conroy S, 2010, MED CRISES OLDER PEO
[10]
Patients with recurrent falls attending Accident & Emergency benefit from multifactorial intervention - a randomised controlled trial [J].
Davison, J ;
Bond, J ;
Dawson, P ;
Steen, IN ;
Kenny, RA .
AGE AND AGEING, 2005, 34 (02) :162-168