Effectiveness of acute geriatric units on functional decline, living at home, and case fatality among older patients admitted to hospital for acute medical disorders: meta-analysis
Authors
Baztan, J. JSuarez-Garcia, F. M
Lopez-Arrieta, J.
Rodríguez-Mañas, Leocadio
Rodríguez Artalejo, Fernando
Affiliation
Hospital Central Cruz Roja, MadridHealth Department, Principado de Asturias, Oviedo, Spain
La Paz-Cantoblanco Universitary Hospital, Madrid
Universitary Hospital, Getafe, Madrid
Universidad Autónoma de Madrid
Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP)
Issue Date
2009-01-22
Metadata
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Objective To assess the effectiveness of acute geriatric units compared with conventional care units in adults aged 65 or more admitted to hospital for acute medical disorders. Design Systematic review and meta-analysis. Data sources Medline, Embase, and the Cochrane Library up to 31 August 2008, and references from published literature. Review methods Randomised trials, non-randomised trials, and case-control studies were included. Exclusions were studies based on administrative databases, those that assessed care for a single disorder, those that evaluated acute and subacute care units, and those in which patients were admitted to the acute geriatric unit after three or more days of being admitted to hospital. Two investigators independently selected the studies and extracted the data. Results 11 studies were included of which five were randomised trials, four non-randomised trials, and two case-control studies. The randomised trials showed that compared with older people admitted to conventional care units those admitted to acute geriatric units had a lower risk of functional decline at discharge (combined odds ratio 0.82, 95% confidence interval 0.68 to 0.99) and were more likely to live at home after discharge (1.30, 1.11 to 1.52), with no differences in case fatality (0.83, 0.60 to 1.14). The global analysis of all studies, including non-randomised trials, showed similar results. Conclusions Care of people aged 65 or more with acute medical disorders in acute geriatric units produces a functional benefit compared with conventional hospital care, and increases the likelihood of living at home after discharge.Citation
Baztan, J.J. et al (2009) 'Effectiveness of acute geriatric units on functional decline, living at home, and case fatality among older patients admitted to hospital for acute medical disorders: meta-analysis' BMJ 338 (jan22 2):b50Publisher
BMJ Publishing GroupJournal
BMJDOI
10.1136/bmj.b50PubMed Central ID
PMC2769066Additional Links
http://www.bmj.com/cgi/doi/10.1136/bmj.b50Type
ArticleLanguage
enISSN
0959-81381468-5833
ae974a485f413a2113503eed53cd6c53
10.1136/bmj.b50
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