A Cochrane review [Abstract] 1 included 8 studies with a total of 1843 subjects. Seven trials recruited people recovering from a hip fracture (n = 1583) and one was elective surgical oncology trial (n = 260). The subjects were aged 65 years and over. For two trials comprehensive geriatric assessment (CGA) was done pre-operatively and in remaining trials postoperatively, it was compared with standard care. CGA probably reduces mortality in older people with hip fracture (RR 0.85, 95% CI 0.68 to 1.05; 5 trials, n=1316). The intervention reduces discharge to an increased level of care (RR 0.71, 95% CI 0.55 to 0.92; 5 trials, n=941).Length of stay was highly heterogeneous, with mean difference between participants allocated to the intervention and the control groups ranging between -12.8 and 8.3 days. CGA can lead to slightly reduced length of stay (4 trials, n=841). The intervention makes little or no difference in re-admission rates (RR 1.00, 95% CI 0.76 to 1.32; 3 trials, n=741).CGA slightly reduces total cost (1 trial, n=397). The intervention makes little or no difference for major postoperative complications (2 trials, n=579) and delirium rates (RR 0.75, 95% CI 0.60 to 0.94; 3 trials, n=705).
Date of latest search:
Primary/Secondary Keywords