Comprehensive geriatric care reduces acute perioperative delirium in elderly patients with hip fractures

Hip fractures may increase mortality and decrease mobility in elderly patients. Effectiveness of comprehensive geriatric care (CGC) has not been verified. A systematic review and a meta-analysis were conducted by searching full-text databases (1988–2018) of Cochrane Library, Clinical Key, Embase, MEDLINE, CINAHL, and ProQuest for randomized controlled trials (RCTs) of CGC following hip fractures. Outcome measures were mortality, activities of daily living, hospital stay, and discharge to institutional setting. Cochrane RoB 2.0, Jadad Quality Score, and Group Reading Assessment were used for analysis. Of the 11 studies included, 8 examined mortality (effect size Z = 2.51, p = 0.01), 5 examined daily activities (effect size Z = 3.31, p = 0.0009), 7 examined length of hospital stay (effect size Z = 0.18, p = 0.85), and 5 examined discharged to an institutional setting (effect size Z = 0.81, p = 0.42). Results showed that CGC decreased mortality and improved daily living activities.

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Hip fractures: comprehensive geriatric care and recovery

The Lancet ◽

10.1016/s0140-6736(14)61592-0 ◽

2015 ◽

Vol 385 (9978) ◽

pp. 1594-1595 ◽

Cited By ~ 8

Author(s):

Stefano Volpato ◽

Jack M Guralnik

Keyword(s):

Hip Fractures ◽

Geriatric Care ◽

Comprehensive Geriatric Care

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Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial

The Lancet ◽

10.1016/s0140-6736(14)62409-0 ◽

2015 ◽

Vol 385 (9978) ◽

pp. 1623-1633 ◽

Cited By ~ 246

Author(s):

Anders Prestmo ◽

Gunhild Hagen ◽

Olav Sletvold ◽

Jorunn L Helbostad ◽

Pernille Thingstad ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Hip Fractures ◽

Controlled Trial ◽

Geriatric Care ◽

Comprehensive Geriatric Care ◽

Randomised Controlled

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The Need for Occupational Therapists in Geriatric Nursing Homes

British Journal of Occupational Therapy ◽

10.1177/030802268404700608 ◽

1984 ◽

Vol 47 (6) ◽

pp. 185-186 ◽

Cited By ~ 1

Author(s):

Sylvia Rodger

Keyword(s):

Nursing Homes ◽

Elderly Patients ◽

Occupational Therapists ◽

Well Being ◽

Geriatric Care ◽

Geriatric Nursing ◽

Unique Contribution ◽

Comprehensive Geriatric Care ◽

Health And Well Being

This article aims to highlight the contribution occupational therapists can make to comprehensive geriatric care. It emphasizes how the philosophy of the profession, as well as the training graduates receive, equip occupational therapists to aid in the maintenance of health and well-being in elderly patients. The specific skills occupational therapists possess which enable them to make a unique contribution to geriatric treatment teams are detailed.

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Comprehensive Geriatric Care to Improve Mobility after Hip Fracture: An RCT

Gerontology ◽

10.1159/000510903 ◽

2020 ◽

Vol 66 (6) ◽

pp. 542-548

Author(s):

Wendy L. Cook ◽

Penelope M.A. Brasher ◽

Pierre Guy ◽

Stirling Bryan ◽

Meghan G. Donaldson ◽

...

Keyword(s):

Hip Fracture ◽

Small Sample Size ◽

Controlled Trial ◽

Geriatric Care ◽

Small Sample ◽

Community Dwelling ◽

Post Discharge ◽

Mobility Performance ◽

Discharge Care ◽

Comprehensive Geriatric Care

Background: Comprehensive geriatric care (CGC) for older adults during hospitalization for hip fracture can improve mobility, but it is unclear whether CGC delivered after a return to community living improves mobility compared with usual post-discharge care. Objective: To determine if an outpatient clinic-based CGC regime in the first year after hip fracture improved mobility performance at 12 months. Methods: A two-arm, 1:1 parallel group, pragmatic, single-blind, single-center, randomized controlled trial at 3 hospitals in Vancouver, BC, Canada. Participants were community-dwelling adults, aged ≥65 years, with a hip fracture in the previous 3–12 months, who had no dementia and walked ≥10 m before the fracture occurred. Target enrollment was 130 participants. Clinic-based CGC was delivered by a geriatrician, physiotherapist, and occupational therapist. Primary outcome was the Short Physical Performance Battery (SPPB; 0–12) at 12 months. Results: We randomized 53/313 eligible participants with a mean (SD) age of 79.7 (7.9) years to intervention (n = 26) and usual care (UC, n = 27), and 49/53 (92%) completed the study. Mean 12-month (SD) SPPB scores in the intervention and UC groups were 9.08 (3.03) and 8.24 (2.44). The between-group difference was 0.9 (95% CI –0.3 to 2.0, p = 0.13). Adverse events were similar in the 2 groups. Conclusion: The small sample size of less than half our recruitment target precludes definitive conclusions about the effect of our intervention. However, our results are consistent with similar studies on this population and intervention.

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