Abstract
Objective
Systematic rehabilitation by geriatric interdisciplinary teams has been associated
with favorable outcomes in frail older patients. The aim of the present meta-analysis
was to evaluate the effects of interdisciplinary geriatric team rehabilitation in
older patients with hip fracture.
Design, setting, and participants
Randomized controlled trials involving participants sustaining hip fractures at the
age of 65 years or older were included. Included trials evaluated effects of interdisciplinary
geriatric team rehabilitation compared with usual postoperative care and reported
on at least one of the following outcomes: activities of daily living (ADLs), physical
function, mobility, depression, cognitive function, discharge to home, quality of
life, influence on relatives, complications, and survival. Seven studies of at least
moderate quality with a total of 1763 participants were included.
Measures
Data were combined using a random-effects model. The GRADE system (1–4, where 4 is
highest level of evidence) was used to rate the quality of the estimates.
Results
Outcomes were grouped into 4 categories, each of which was reported on in at least
4 studies: ADL/physical function, mobility, living in one's own home, and survival.
Interdisciplinary geriatric team rehabilitation increased ADL/physical function (standardized
mean difference [SMD], 0.32; 95% confidence interval [CI], 0.17–0.47) and mobility
(SMD, 0.32; 95% CI, 0.12–0.52) compared with conventional care. In contrast, interdisciplinary
geriatric team rehabilitation did not increase the chance of living in one's own home
after discharge (risk ratio [RR], 1.07; 95% CI, 0.99–1.16) or survival (RR, 1.02;
95% CI, 0.99–1.06) compared with conventional care. All results were rated as GRADE 3.
Conclusion
Systematic rehabilitation by geriatric interdisciplinary teams increases physical
function and mobility significantly compared with conventional care in patients with
hip fracture. In contrast, the chance of being discharged to one's own home and survival
are not influenced.
Keywords
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Article info
Publication history
Published online: June 26, 2018
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
