AI Article Synopsis
- The elderly population faces higher risks of complications after surgery, and comprehensive geriatric assessments may help lower these risks, but their effectiveness is not confirmed.
- A literature review of randomized trials involving patients aged 65 and older was conducted, analyzing the impact of comprehensive geriatric assessment on postoperative outcomes.
- The findings showed that while these assessments reduced postoperative delirium, they did not significantly affect other outcomes such as length of hospital stay, readmission rates, or activities of daily living, indicating a need for more quality research on the subject.
Article Abstract
Introduction: The elderly population experiences more postoperative complications. A comprehensive geriatric assessment, which is multidimensional and coordinated, could help reduce these unfavorable outcomes. However, its effectiveness is still uncertain.
Methods: We searched multiple online databases, including Medline, PubMed, Web of Science, Cochrane Library, Embase, CINAL, ProQuest, and Wiley, for relevant literature from their inception to October 2023. We included randomized trials of individuals aged 65 and older undergoing surgery. These trials compared comprehensive geriatric assessment with usual surgical care and reported on postoperative outcomes. Two researchers independently screened the literature, extracted data, and assessed the certainty of evidence from the identified articles. We conducted a meta-analysis using RevMan 5.3 to calculate the Odds Ratio (OR) and Mean Difference (MD) of the pooled data.
Results: The study included 1325 individuals from seven randomized trials. Comprehensive geriatric assessment reduced the rate of postoperative delirium (28.5% vs. 37.0%; OR: 0.63; CI: 0.47-0.85; I2: 54%; P = 0.003) based on pooled data. However, it did not significantly improve other parameters such as length of stay (MD: -0.36; 95% CI: -0.376, 3.05; I2: 96%; P = 0.84), readmission rate (18.6% vs. 15.4%; OR: 1.26; CI: 0.86-1.84; I2: 0%; P = 0.24), and ADL function (MD: -0.24; 95% CI: -1.27, 0.19; I2: 0%; P = 0.64).
Conclusions: Apart from reducing delirium, it is still unclear whether comprehensive geriatric assessment improves other postoperative outcomes. More evidence from higher-quality randomized trials is needed.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356442 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0306308 | PLOS |
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