Geriatric team support in the emergency department—a randomised trial investigating the effects on hospital admission and community care in older adults (GerED-21).
Background The Emergency Department (ED) is a 'strategic crossroads' for geriatric care, as older adults represent nearly 50% of ED visits resulting in hospital admissions. It is therefore essential to integrate geriatric expertise within the ED to address their complex needs and improve outcomes. A...
| Publicado en: | Age & Ageing Vol. 55; no. 6; pp. 1 - 13 |
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| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Jun2026
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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=195099728&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195099728 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: Jun2026 vid: 55 iid: 6 pid: 622 pub: Oxford University Press / USA artinfo: ui: 195099728 10.1093/ageing/afag180 ppf: 1 ppct: 12 formats: tig: atl: Geriatric team support in the emergency department—a randomised trial investigating the effects on hospital admission and community care in older adults (GerED-21). aug: au: Lunardelli, Maria L Gibertoni, Dino Colantoni, Alessandra Bendini, Chiara Forti, Paola Notariis, Stefania De Maioli, Fabiola Petroni, Manuela Nardelli, Anna Modugno, Maria affil: Geriatric Acute Care, Orthogeriatric Unit & Centre for Diagnosis of Cognitive Disorders and Dementia, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna, Italy Epidemiology and Statistics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy Inter-institutional Department of Emergency Medicine, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy Department of Medical and Surgical Sciences, University of Bologna, Bologna, ItalyIRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy Inter-institutional Department of Emergency Medicine - Unit for Urgent care in older and frail adults, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy Department of Integration, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy Department of Technical Health and Rehabilitation Assistance (DATeR), Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy Geriatric Unit, Inter-institutional Department of Continuity and Complexity, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy su: Italy Community health services Mortality Patients Hospital admission & discharge Randomized controlled trials Social support Hospital care of older people Mental health surveys T-test (Statistics) Research funding Emergency room visits Fisher exact test Multiple regression analysis Questionnaires Patient readmissions Hospital emergency services Mann Whitney U Test Chi-squared test Kaplan-Meier estimator Log-rank test Geriatric assessment Research Cluster sampling Medical care for older people Data analysis software Health care teams Proportional hazards models Regression analysis sug: subj: Community health services Mortality Patients Hospital admission & discharge Randomized controlled trials Social support Hospital care of older people Italy Other local, municipal and regional public administration Other Individual and Family Services Residential Mental Health and Substance Abuse Facilities Community health centres All Other Outpatient Care Centers Mental health surveys T-test (Statistics) Research funding Emergency room visits Fisher exact test Multiple regression analysis Questionnaires Patient readmissions Hospital emergency services Mann Whitney U Test Chi-squared test Kaplan-Meier estimator Log-rank test Geriatric assessment Research Cluster sampling Medical care for older people Data analysis software Health care teams Proportional hazards models Regression analysis keyword: aged aging comprehensive geriatric assessment copyrightHolder:British Geriatrics Society copyrightYear:2026 emergency department emergency service frailty geriatrics hospital hospital admission hospital admissions https://dx.doi.org/10.1093/ageing/afag180 inLanguage:en mortality older adults publisher:Oxford University Press randomization sameAs:https://pubmed.ncbi.nlm.nih.gov/42348848/ aged aging comprehensive geriatric assessment copyrightHolder:British Geriatrics Society copyrightYear:2026 emergency department emergency service frailty geriatrics hospital hospital admission hospital admissions https://dx.doi.org/10.1093/ageing/afag180 inLanguage:en mortality older adults publisher:Oxford University Press randomization sameAs:https://pubmed.ncbi.nlm.nih.gov/42348848/ ab: Background The Emergency Department (ED) is a 'strategic crossroads' for geriatric care, as older adults represent nearly 50% of ED visits resulting in hospital admissions. It is therefore essential to integrate geriatric expertise within the ED to address their complex needs and improve outcomes. Aims This study evaluated whether implementing a Geriatric Team (GT) comprising geriatricians, nurses, social workers, tasked with conducting Comprehensive Geriatric Assessment and delivering tailored interventions in the ED, could reduce unnecessary hospital admissions and repeated ED visits compared to standard practice. Materials and methods A multicentre, parallel, unblinded, superiority randomised study was conducted on people aged 75 years or older who scored ≥2 on the Triage Risk Stratification Tool upon ED admission. Randomisation was computer-generated and applied to calendar weeks. The primary outcome was hospital admission at the index ED visit. The secondary outcomes were ED readmissions; hospitalisations; mortality at 7, 30 and 90 days; and functional status at 30 and 90 days. Results The study included 624 participants, 314 (50.3%) in the GT group and 310 (49.7%) in the usual care group. Hospital admissions at the index ED visit were 13.7% in the GT and 56.8% in the usual care group. ED readmission and hospitalisation rates were similar across groups. All-cause 30-day mortality was similar across groups, while 90-day mortality was lower in the intervention group. Functional decline was attenuated at both 30 and 90 days in the GT group. Conclusions By relieving pressure on inpatient services, the GT integration into ED workflows represents a scalable strategy for health systems facing demographic shifts and rising demand for age-sensitive care. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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