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Frailty and comprehensive geriatric assessment organized as CGA-ward or CGA-consult for older adult patients in the acute care setting: A systematic review and meta-analysis

Ekdahl, A.W. LU ; Sjöstrand, Fredrik; Ehrenberg, Anna; Oredsson, S.; Stavenow, L.; Wisten, A.; Wårdh, I. and Dahlin Ivanoff, S (2015) In European Geriatric Medicine 6(6). p.523-540
Abstract
With worldwide population aging, increasing numbers of people need hospital care. Evidence suggests comprehensive geriatric assessment (CGA) is superior to usual care. To summarize the evidence for the effects of CGA in frail and moderately frail patients compared with usual care in acute care settings. CINAHL, PsycInfo, Cochrane Library, EMBASE, and PubMed were searched in October 2011, January 2013, and February 2015. Randomized controlled trials. CGA. Usual care. Change in housing, personal activities of daily living (PADL), instrumental activities of daily living (IADL), readmission, cognitive function, depression, quality-of-life care-giver burden, and mortality. The grading of recommendations assessment development and evaluation... (More)
With worldwide population aging, increasing numbers of people need hospital care. Evidence suggests comprehensive geriatric assessment (CGA) is superior to usual care. To summarize the evidence for the effects of CGA in frail and moderately frail patients compared with usual care in acute care settings. CINAHL, PsycInfo, Cochrane Library, EMBASE, and PubMed were searched in October 2011, January 2013, and February 2015. Randomized controlled trials. CGA. Usual care. Change in housing, personal activities of daily living (PADL), instrumental activities of daily living (IADL), readmission, cognitive function, depression, quality-of-life care-giver burden, and mortality. The grading of recommendations assessment development and evaluation (GRADE) system to assess the quality of evidence and PRISMA-guidelines for meta-analyses and reviews. Continuous data were presented as standardized mean differences and dichotomous data were presented as risk differences. Twenty-nine articles based on 17 unique studies (6005 patients in total). CGA was categorized as CGA-ward or CGA-consult. In the frail group, CGA-ward was superior to usual care for change in housing, PADL, and depression. CGA-consult was superior to usual care for PADL and IADL in the moderately frail group. There was a stronger effect for frail older adults and CGA-ward compared with usual care. This highlights the importance of detecting frailty. However, the degree of evidence was limited. (Less)
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author
publishing date
type
Contribution to journal
publication status
published
keywords
Acute care, Comprehensive geriatric assessment, Frailty, Meta-analysis, Systematic review, article, attributable risk, caregiver, caregiver burden, Cinahl, Cochrane Library, cognition, comprehensive geriatric assessment, daily life activity, depression, Embase, emergency care, follow up, frail elderly, geriatric assessment, hospital admission, hospital readmission, housing, human, Medline, meta analysis, mortality, priority journal, PsycINFO, quality of life, randomized controlled trial (topic), systematic review
in
European Geriatric Medicine
volume
6
issue
6
pages
18 pages
publisher
Elsevier Masson SAS
external identifiers
  • scopus:84961720911
ISSN
1878-7649
DOI
10.1016/j.eurger.2015.10.007
language
English
LU publication?
no
id
c72424ae-dd98-43e2-b173-fc12d2b341a9
date added to LUP
2017-05-21 10:13:33
date last changed
2017-05-28 05:00:20
@article{c72424ae-dd98-43e2-b173-fc12d2b341a9,
  abstract     = {With worldwide population aging, increasing numbers of people need hospital care. Evidence suggests comprehensive geriatric assessment (CGA) is superior to usual care. To summarize the evidence for the effects of CGA in frail and moderately frail patients compared with usual care in acute care settings. CINAHL, PsycInfo, Cochrane Library, EMBASE, and PubMed were searched in October 2011, January 2013, and February 2015. Randomized controlled trials. CGA. Usual care. Change in housing, personal activities of daily living (PADL), instrumental activities of daily living (IADL), readmission, cognitive function, depression, quality-of-life care-giver burden, and mortality. The grading of recommendations assessment development and evaluation (GRADE) system to assess the quality of evidence and PRISMA-guidelines for meta-analyses and reviews. Continuous data were presented as standardized mean differences and dichotomous data were presented as risk differences. Twenty-nine articles based on 17 unique studies (6005 patients in total). CGA was categorized as CGA-ward or CGA-consult. In the frail group, CGA-ward was superior to usual care for change in housing, PADL, and depression. CGA-consult was superior to usual care for PADL and IADL in the moderately frail group. There was a stronger effect for frail older adults and CGA-ward compared with usual care. This highlights the importance of detecting frailty. However, the degree of evidence was limited.},
  author       = {Ekdahl, A.W. and Sjöstrand, Fredrik and Ehrenberg, Anna and Oredsson, S. and Stavenow, L. and Wisten, A. and Wårdh, I. and Dahlin Ivanoff, S},
  issn         = {1878-7649},
  keyword      = {Acute care,Comprehensive geriatric assessment,Frailty,Meta-analysis,Systematic review,article,attributable risk,caregiver,caregiver burden,Cinahl,Cochrane Library,cognition,comprehensive geriatric assessment,daily life activity,depression,Embase,emergency care,follow up,frail elderly,geriatric assessment,hospital admission,hospital readmission,housing,human,Medline,meta analysis,mortality,priority journal,PsycINFO,quality of life,randomized controlled trial (topic),systematic review},
  language     = {eng},
  month        = {05},
  number       = {6},
  pages        = {523--540},
  publisher    = {Elsevier Masson SAS},
  series       = {European Geriatric Medicine},
  title        = {Frailty and comprehensive geriatric assessment organized as CGA-ward or CGA-consult for older adult patients in the acute care setting: A systematic review and meta-analysis},
  url          = {http://dx.doi.org/10.1016/j.eurger.2015.10.007},
  volume       = {6},
  year         = {2015},
}