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Effects of Geriatric Team Rehabilitation After Hip Fracture: Meta-Analysis of Randomized Controlled Trials
Department of Community Medicine and Rehabilitation, Geriatrics, Umeå University, Umeå, Sweden.
Department of Clinical Sciences, Orthopedics, Lund University, Lund, Sweden.
Department of Clinical Sciences, Orthopedics, Lund University, Lund, Sweden.ORCID iD: 0000-0002-6114-6535
Department of Clinical Neuroscience and Rehabilitation, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
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2018 (English)In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 19, no 10, p. 840-845Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Elsevier, 2018. Vol. 19, no 10, p. 840-845
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:mau:diva-55975DOI: 10.1016/j.jamda.2018.05.008ISI: 000445790500006PubMedID: 29958818Scopus ID: 2-s2.0-85048989630OAI: oai:DiVA.org:mau-55975DiVA, id: diva2:1710342
Available from: 2022-11-11 Created: 2022-11-11 Last updated: 2023-07-05Bibliographically approved

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