• Int J Clin Exp Med · Jan 2015

    Review

    The influence of inpatient comprehensive geriatric care on elderly patients with hip fractures: a meta-analysis of randomized controlled trials.

    • Huichao Wang, Chunbo Li, Ying Zhang, Yudong Jia, Yingjie Zhu, Ruibo Sun, Wuyin Li, and Youwen Liu.
    • Luoyang Orthopedic Hospital of Henan Province, Orthopedic Institute of Henan Province Luoyang 471002, China.
    • Int J Clin Exp Med. 2015 Jan 1; 8 (11): 19815-30.

    ObjectiveTo evaluate the efficacy of in-patient comprehensive geriatric care for elderly patients with hip fracture.MethodsRelevant literatures were searched using the following databases including PubMed, OVID, Web of science, Scopus, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trails until August 1, 2015. Eligible studies were restricted to randomized controlled trials (RCTs). The available data was extracted by two independent authors and pooled through using Review manager version 5.2. For data deemed not appropriate for synthesis, a narrative overview was conducted.Results15 trials evaluating 3458 participants were identified in our meta-analysis. Our findings indicated patients who underwent comprehensive geriatric cares showed no significant greater improvement than control in in-patient mortality (Odds risk (OR) 0.73, 95% confidence interval (CI) 0.51 to 1.05, P=0.09), 3-(OR 0.96, 95% CI 0.51 to 1.81, P=0.90), 6-(OR 1.03, 95% CI 0.73 to 1.45, P=0.86) and 12-months mortality (OR 0.93, 95% CI 0.77 to 1.12, P=0.30). The proportion of patients who were discharged from hospital to the same place of residence as before the fracture was higher in intervention group than control (OR 1.67, 95% CI 0.80 to 3.37, P=0.0003). In addition, the pooled results showed that the number of patients in intervention group who had regained the same level of activities of daily living (ADL) (43.9% vs 30.2%, 46.0% vs 29.1%) and walking ability (71.3% vs 53.2%, 68.9% vs 56.3%) as before the fracture was higher than control at 3 and 12 months after discharge, respectively.ConclusionComprehensive geriatric care promoted the functional improvement for elderly patients with hip fracture. Meanwhile, the proportion of patients who were discharged from hospital to the same place as before fracture in intervention group was higher as compared to control. However, our finding showed no significant difference on in-patients mortality, follow-up mortality and length of stay between both groups.

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