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Effectiveness of in-hospital geriatric co-management: a systematic review and meta-analysis

Van Grootven, Bastiaan and Flamaing, Johan and Dierckx de Casterlé, Bernadette and Dubois, Christophe and Fagard, Katleen and Herregods, Marie-Christine and Hornikx, Miek and Laenen, Annouschka and Meuris, Bart and Rex, Steffen and Tournoy, Jos and Milisen, Koen and Deschodt, Mieke. (2017) Effectiveness of in-hospital geriatric co-management: a systematic review and meta-analysis. Age and ageing, 46 (6). pp. 903-910.

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Official URL: https://edoc.unibas.ch/59866/

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Abstract

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.; to conduct a systematic review of the effectiveness of in-hospital geriatric co-management.; MEDLINE, EMBASE, CINAHL and CENTRAL were searched from inception to 6 May 2016. Reference lists, trial registers and PubMed Central Citations were additionally searched.; 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.; standardised data extraction and assessment of risk of bias were performed independently by two investigators.; 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).; there was low-quality evidence of a reduced length of stay and a reduced number of patients with complications, and very low-quality evidence of better functional status as a result of geriatric co-management.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Institut für Pflegewissenschaft
UniBasel Contributors:Deschodt, Mieke
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1468-2834
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:27 Apr 2020 12:35
Deposited On:27 Apr 2020 12:35

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