Effectiveness of in-hospital geriatric co-management: a systematic review and meta-analysis.
Background: geriatric consultation teams have failed to impact clinical outcomes prompting geriatric co-management programmes to emerge as a promising strategy to manage frail patients on non-geriatric wards. Objective: to conduct a systematic review of the effectiveness of in-hospital geriatric co-...
| Publicado en: | Age & Ageing Vol. 46; no. 6; pp. 903 - 911 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Nov2017
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=125888809&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 125888809 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Nov2017 vid: 46 iid: 6 pid: 622 pub: Oxford University Press / USA artinfo: ui: 125888809 10.1093/ageing/afx051 ppf: 903 ppct: 8 formats: tig: atl: Effectiveness of in-hospital geriatric co-management: a systematic review and meta-analysis. aug: au: VAN GROOTVEN, BASTIAAN FLAMAING, JOHAN DIERCKX DE CASTERLÉ, BERNADETTE DUBOIS, CHRISTOPHE FAGARD, KATLEEN HERREGODS, MARIE-CHRISTINE HORNIKX, MIEK LAENEN, ANNOUSCHKA MEURIS, BART REX, STEFFEN TOURNOY, JOS MILISEN, KOEN DESCHODT, MIEKE affil: Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium Department of Clinical and Experimental Medicine, KU Leuven - University of Leuven, Leuven, Belgium Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium Department of Cardiovascular Sciences, KU Leuven - University of Leuven, Leuven, Belgium Department of Cardiovascular Diseases, KU Leuven - University of Leuven, University Hospitals Leuven, Leuven, Belgium Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat), KU Leuven - University of Leuven, Leuven, Belgium Department of Cardiovascular Sciences, KU Leuven -- University of Leuven, Leuven, Belgium Department of Anaesthesiology, University Hospitals Leuven, Leuven, Belgium Department of Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland su: Elder care Hospital care of older people Life skills Treatment effectiveness CINAHL database Confidence intervals Length of stay in hospitals Medical information storage & retrieval systems MEDLINE Meta-analysis Online information services Systematic reviews Descriptive statistics Odds ratio sug: subj: Elder care Hospital care of older people Life skills Continuing Care Retirement Communities Treatment effectiveness CINAHL database Confidence intervals Length of stay in hospitals Medical information storage & retrieval systems MEDLINE Meta-analysis Online information services Systematic reviews Descriptive statistics Odds ratio keyword: Co-management frail geriatric older people outcome review systematic review Co-management frail geriatric older people outcome review systematic review ab: Background: geriatric consultation teams have failed to impact clinical outcomes prompting geriatric co-management programmes to emerge as a promising strategy to manage frail patients on non-geriatric wards. Objective: to conduct a systematic review of the effectiveness of in-hospital geriatric co-management. Data sources: MEDLINE, EMBASE, CINAHL and CENTRAL were searched from inception to 6 May 2016. Reference lists, trial registers and PubMed Central Citations were additionally searched. Study selection: randomised controlled trials and quasi-experimental studies of in-hospital patients included in a geriatric co-management study. Two investigators performed the selection process independently. Data extraction: standardised data extraction and assessment of risk of bias were performed independently by two investigators. Results: twelve studies and 3,590 patients were included from six randomised and six quasi-experimental studies. Geriatric co-management improved functional status and reduced the number of patients with complications in three of the four studies, but studies had a high risk of bias and outcomes were measured heterogeneously and could not be pooled. Co- management reduced the length of stay (pooled mean difference, -1.88 days [95% CI, -2.44 to -1.33]; 11 studies) and may reduce in-hospital mortality (pooled odds ratio, 0.72 [95% CI, 0.50-1.03]; 7 studies). Meta-analysis identified no effect on the number of patients discharged home (5 studies), post-discharge mortality (3 studies) and readmission rate (4 studies). Conclusions: there was low-quality evidence of a reduced length of stay and a reduced number of patients with complica- tions, and very low-quality evidence of better functional status as a result of geriatric co-management. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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