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

2.50
Hdl Handle:
http://hdl.handle.net/10547/593444
Title:
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. J; Suarez-Garcia, F. M; Lopez-Arrieta, J.; Rodríguez-Mañas, Leocadio; Rodriguez-Artalejo, F.
Abstract:
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.
Affiliation:
Hospital Central Cruz Roja, Madrid; Health 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)
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):b50
Publisher:
BMJ Publishing Group
Journal:
BMJ
Issue Date:
22-Jan-2009
URI:
http://hdl.handle.net/10547/593444
DOI:
10.1136/bmj.b50
PubMed Central ID:
PMC2769066
Additional Links:
http://www.bmj.com/cgi/doi/10.1136/bmj.b50
Type:
Article
Language:
en
ISSN:
0959-8138; 1468-5833
Appears in Collections:
IHR Institute for Health Research

Full metadata record

DC FieldValue Language
dc.contributor.authorBaztan, J. Jen
dc.contributor.authorSuarez-Garcia, F. Men
dc.contributor.authorLopez-Arrieta, J.en
dc.contributor.authorRodríguez-Mañas, Leocadioen
dc.contributor.authorRodriguez-Artalejo, F.en
dc.date.accessioned2016-01-14T11:44:48Zen
dc.date.available2016-01-14T11:44:48Zen
dc.date.issued2009-01-22en
dc.identifier.citationBaztan, 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):b50en
dc.identifier.issn0959-8138en
dc.identifier.issn1468-5833en
dc.identifier.doi10.1136/bmj.b50en
dc.identifier.urihttp://hdl.handle.net/10547/593444en
dc.description.abstractObjective 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.en
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.relation.urlhttp://www.bmj.com/cgi/doi/10.1136/bmj.b50en
dc.rightsArchived with thanks to BMJen
dc.subjectacute geriatric unitsen
dc.subjectfunctional declineen
dc.subjectliving at homeen
dc.subjectgeriatric medicineen
dc.subjectolder adultsen
dc.subjectelderlyen
dc.titleEffectiveness of acute geriatric units on functional decline, living at home, and case fatality among older patients admitted to hospital for acute medical disorders: meta-analysisen
dc.typeArticleen
dc.contributor.departmentHospital Central Cruz Roja, Madriden
dc.contributor.departmentHealth Department, Principado de Asturias, Oviedo, Spainen
dc.contributor.departmentLa Paz-Cantoblanco Universitary Hospital, Madriden
dc.contributor.departmentUniversitary Hospital, Getafe, Madriden
dc.contributor.departmentUniversidad Autónoma de Madriden
dc.contributor.departmentBiomedical Research Centre Network for Epidemiology and Public Health (CIBERESP)en
dc.identifier.journalBMJen
dc.identifier.pmcidPMC2769066en
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