Are there benefits to comprehensive geriatric assessments in hospitalized patients?

January 01, 0001

Are there benefits to comprehensive geriatric assessments in hospitalized patients?

These Irish and Scottish researchers examined the use of comprehensive geriatric assessments in hospitalized patients. They define comprehensive geriatric assessment as "a multidimensional interdisciplinary diagnostic process used to determine the medical, psychological, and functional capabilities of a frail elderly person to develop a coordinated and integrated plan for treatment and long term follow-up." They searched the EPOC Register, Cochrane’s Controlled Trials Register, the Database of Abstracts of Reviews of Effects, Medline, Embase, CINAHL, AARP Ageline, and handsearched journals thought to be of particular interest for ramdomized controlled trials of comprehensive geriatric assessment versus usual care.

The researchers found: "Twenty two trials evaluating 10?315 participants in six countries were identified. For the primary outcome "living at home," patients who underwent comprehensive geriatric assessment were more likely to be alive and in their own homes at the end of scheduled follow-up (odds ratio 1.16, number needed to treat 33) at a median follow-up of 12 months versus 1.25 (number needed to treat 17) at a median follow-up of six months) compared with patients who received general medical care. In addition, patients were less likely to be living in residential care (0.78). Subgroup interaction suggested differences between the subgroups "wards" and "teams" in favour of wards. Patients were also less likely to die or experience deterioration (0.76) and were more likely to experience improved cognition (standardised mean difference 0.08) in the comprehensive geriatric assessment group."

The researchers concluded: "Comprehensive geriatric assessment increases patients’ likelihood of being alive and in their own homes after an emergency admission to hospital. This seems to be especially true for trials of wards designated for comprehensive geriatric assessment and is associated with a potential cost reduction compared with general medical care."

This study identifies benefits such as increased independence, improved function, and less mortality when comprehensive geriatric assessments are used in hospitalized patients.

For the full abstract, click here.

BMJ 343:d6553, 27 October 2011 © 2011 BMJ Publishing Group Ltd.
Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials. Graham Ellis, Martin A Whitehead, David Robinson, Desmond O’Neill, Peter Langhorne. Correspondence to G Ellis: Graham.ellis@lanarkshire.scot.nhs.uk

Category: A. General/Unspecified. Keywords: comprehensive geriatric assessment, hospitalization, elderly, independence, mortality, systematic review and meta-analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 15 November 2011/span>

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