Is the acute care of frail elderly patients in a  comprehensive geriatric assessment unit superior to conventional acute medical care?

Ekerstad, Niklas; Karlson, Björn W.; Ivanoff, Synneve Dahlin; Landahl, Sten; Andersson, David; Heintz, Emelie; Husberg, Magnus; Alwin, Jenny

doi:10.2147/cia.s124003

Cited by 50 publications

(71 citation statements)

References 26 publications

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“…The group of frail older people is increasing due to ageing and an increase in life expectancy [6]. A high percentage of emergency patients are frail older patients, and they are the fastest growing group in primary care [6,8,9].…”

Section: Introductionmentioning

confidence: 99%

Cross-cultural adaptation and validation of the PRISMA-7 scale for European Portuguese

Santiago¹,

Silva²,

Velho³

et al. 2020

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Background. Frailty is an age-associated biological syndrome and a predictor of multimorbidity outcomes, whose early recognition allows for the identification of those older patients at risk. The PRISMA-7 scale allows for the identification of frail older people. Objectives. To make a cross-cultural adaptation and validation of the PRISMA-7 to the European spoken Portuguese language. Material and methods. Cross-cultural adaptation by translation of the PRISMA-7 scale into European Portuguese, debriefing and back-translation to English. Application for intra-observer reliability assessment and validation by simultaneous and concurrent application of the Katz scale. Results. Cronbach's alpha coefficient was of 0.420 and 0.409 after a re-test. Spearman's Rank Order Correlation of 0.969 in the re-test operation in a sample of 64 older people (35 female). More than 3 affirmative answers were found for older people (p < 0.001), for a higher number of self-reported drugs taken, (p = 0.001), self-reported years of education (p = 0.001), higher values for those with less years of studies were found in the validation of the translated PRISMA-7 scale, in a purposive sample of 127 older people, 72 (56.7%) female. No differences were found between gender (p = 0.414) and for number of self-reported diseases (p = 0.258). A Spearman correlation of ρ = 0.477 (p < 0.001) between the total of the two scales was found. Discussion. This comprehensive tool enables health care providers to discuss and architect more effective and efficient measures for these patients' care, regardless of gender, socio-demographic factors, number of self-reported drugs taken and diseases. Conclusions. The PRISMA-7 scale is now recommended to identify frail older people in the Portuguese community.

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Section: Introductionmentioning

confidence: 99%

Cross-cultural adaptation and validation of the PRISMA-7 scale for European Portuguese

Santiago¹,

Silva²,

Velho³

et al. 2020

fmpcr

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“…In addition, for frail patients, management in an AGW was associated with lower mortality at 3 months (HR=0.55; 95% CI=0.32-0.96), lower risk of an increasing degree of frailty (OR=0.23; 95% CI=0.13-0.4), and lower risk of decline in activities of daily living (OR=0.093; 95% CI=0.052-0.164). 27,28…”

Section: Acute Geriatric Wardsmentioning

confidence: 99%

Frailty assessment: clinical application in the hospital setting

Wong¹

2018

Hong Kong Med J

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Because of their heterogeneous health status, older people's health care needs differ. The concept of frailty, characterised by a decline in physiological reserve with increased vulnerability to stress, is emerging in clinical practice. Characterising older people by frailty could help to predict their prognosis and health outcomes. Further, consideration of frailty in clinical practice could facilitate the determination of patient-centred goals for effective care delivery. In the hospital setting, identification of frailty could guide management plans for older patients upon disposal from emergency departments; risk stratification by frailty allows appropriate decision making about surgical or invasive interventions; selection of frail people to acute geriatric wards for integrated care improves outcomes; end-of-life care for people at advanced stages of frailty improves the Frailty assessment: clinical application in the hospital setting

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“…The CGA, within a Swedish community setting, has recently proven successful in maintaining/improving independence in activities of daily living (ADL) [22] as has the CGA in outpatient care [23]. One recent controlled study of an acute CGA unit reported the positive effects on health-related quality of life and mortality without higher costs [24]. Besides these studies, recent studies within Swedish acute care are scarce.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Geriatric Assessment for Frail Older People in Swedish Acute Care Settings (CGA-Swed): A Randomised Controlled Study

et al. 2020

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The aim of the study is to evaluate the effects of the Comprehensive Geriatric Assessment (CGA) for frail older people in Swedish acute hospital settings – the CGA-Swed study. In this study protocol, we present the study design, the intervention and the outcome measures as well as the baseline characteristics of the study participants. The study is a randomised controlled trial with an intervention group receiving the CGA and a control group receiving medical assessment without the CGA. Follow-ups were conducted after 1, 6 and 12 months, with dependence in activities of daily living (ADL) as the primary outcome measure. The study group consisted of frail older people (75 years and older) in need of acute medical hospital care. The study design, randomisation and process evaluation carried out were intended to ensure the quality of the study. Baseline data show that the randomisation was successful and that the sample included frail older people with high dependence in ADL and with a high comorbidity. The CGA contributed to early recognition of frail older people’s needs and ensured a care plan and follow-up. This study is expected to show positive effects on frail older people’s dependence in ADL, life satisfaction and satisfaction with health and social care.

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Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care?

Cited by 50 publications

References 26 publications

Cross-cultural adaptation and validation of the PRISMA-7 scale for European Portuguese

Cross-cultural adaptation and validation of the PRISMA-7 scale for European Portuguese

Frailty assessment: clinical application in the hospital setting

Comprehensive Geriatric Assessment for Frail Older People in Swedish Acute Care Settings (CGA-Swed): A Randomised Controlled Study

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