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The effectiveness of the comprehensive geriatric assessment for older adults with frailty in hospital settings: A systematic review and meta-analysis
International Journal of Nursing Studies ( IF 7.5 ) Pub Date : 2024-07-02 , DOI: 10.1016/j.ijnurstu.2024.104849 Yiran Xu 1 , Tianliang Ji 2 , Xin Li 1 , Yali Yang 1 , Lishuang Zheng 1 , Yiming Qiu 1 , Li Chen 3 , Guichen Li 1
International Journal of Nursing Studies ( IF 7.5 ) Pub Date : 2024-07-02 , DOI: 10.1016/j.ijnurstu.2024.104849 Yiran Xu 1 , Tianliang Ji 2 , Xin Li 1 , Yali Yang 1 , Lishuang Zheng 1 , Yiming Qiu 1 , Li Chen 3 , Guichen Li 1
Affiliation
Comprehensive geriatric assessment (CGA) is performed by a multidisciplinary team and includes systematic comprehensive team assessment and treatment. Comprehensive geriatric assessment has become a fundamental component of geriatric nursing, as a multidimensional approach is necessary to achieve the best diagnosis and therapy for older adults with frailty. The aim of our review was to analyze the effects of comprehensive geriatric assessment interventions on older adults with frailty in hospital settings. The PubMed, Web of Science, Embase, CINAHL and Cochrane Library databases were systematically searched from inception to February 28, 2024. Only randomized controlled trials were included in the analysis. The risk ratios (RRs) or standardized mean differences (SMDs) were calculated to determine the pooled intervention effects. Sensitivity analyses and publication bias analyses were also conducted. Methodological quality and evidence were assessed using the RoB2 tool and GRADE pro online tool. A total of 18 randomized controlled trials were included in this review. The results showed that participants in the intervention group had a lower risk of having decreased activities of daily living than did those in the control group (RR = 0.55, 95 % CI: 0.33 to 0.92, = 0.021, low certainty evidence). Comprehensive geriatric assessment was associated with a reduced mortality risk (RR = 0.85, 95 % CI: 0.73 to 0.99, = 0.038, high certainty evidence). In conclusion, this systematic review analyzed the available literature, and the results showed that comprehensive geriatric assessment had significant benefits in terms of increased independence and was associated with a reduced mortality risk for older adults with frailty in hospital settings. However, the evidence was limited. Thus, more research is needed in the future to further enrich the evidence in the field of comprehensive geriatric assessment interventions for older adults with frailty.
中文翻译:
对医院环境中虚弱老年人进行综合老年评估的有效性:系统评价和荟萃分析
综合老年评估(CGA)由多学科团队进行,包括系统的综合团队评估和治疗。全面的老年评估已成为老年护理的基本组成部分,因为需要多维方法才能为体弱的老年人实现最佳诊断和治疗。我们综述的目的是分析综合老年评估干预措施对医院环境中体弱老年人的影响。从成立到 2024 年 2 月 28 日,对 PubMed、Web of Science、Embase、CINAHL 和 Cochrane 图书馆数据库进行了系统检索。分析中仅纳入随机对照试验。计算风险比(RR)或标准化平均差(SMD)以确定汇总干预效果。还进行了敏感性分析和发表偏倚分析。使用 RoB2 工具和 GRADE pro 在线工具评估方法学质量和证据。本次评价共纳入 18 项随机对照试验。结果显示,干预组参与者日常生活活动减少的风险低于对照组(RR = 0.55,95% CI:0.33至0.92,= 0.021,低质量证据)。综合老年评估与降低死亡风险相关(RR = 0.85,95% CI:0.73 至 0.99,= 0.038,高确定性证据)。总之,本系统综述分析了现有文献,结果表明,综合老年评估在增强独立性方面具有显着益处,并且与降低医院环境中虚弱老年人的死亡风险相关。然而,证据有限。 因此,未来需要更多的研究来进一步丰富针对衰弱老年人的综合老年评估干预领域的证据。
更新日期:2024-07-02
中文翻译:
对医院环境中虚弱老年人进行综合老年评估的有效性:系统评价和荟萃分析
综合老年评估(CGA)由多学科团队进行,包括系统的综合团队评估和治疗。全面的老年评估已成为老年护理的基本组成部分,因为需要多维方法才能为体弱的老年人实现最佳诊断和治疗。我们综述的目的是分析综合老年评估干预措施对医院环境中体弱老年人的影响。从成立到 2024 年 2 月 28 日,对 PubMed、Web of Science、Embase、CINAHL 和 Cochrane 图书馆数据库进行了系统检索。分析中仅纳入随机对照试验。计算风险比(RR)或标准化平均差(SMD)以确定汇总干预效果。还进行了敏感性分析和发表偏倚分析。使用 RoB2 工具和 GRADE pro 在线工具评估方法学质量和证据。本次评价共纳入 18 项随机对照试验。结果显示,干预组参与者日常生活活动减少的风险低于对照组(RR = 0.55,95% CI:0.33至0.92,= 0.021,低质量证据)。综合老年评估与降低死亡风险相关(RR = 0.85,95% CI:0.73 至 0.99,= 0.038,高确定性证据)。总之,本系统综述分析了现有文献,结果表明,综合老年评估在增强独立性方面具有显着益处,并且与降低医院环境中虚弱老年人的死亡风险相关。然而,证据有限。 因此,未来需要更多的研究来进一步丰富针对衰弱老年人的综合老年评估干预领域的证据。