Table 4.
Recommendations about comprehensive geriatric assessment
| # | Recommendation | Strength of recommendation |
|---|---|---|
| R1a.1 | Using comprehensive geriatric assessment is suggested to reduce hospitalization rate in older people referred to general practice and primary care | Weak in favor |
| R1a.2 | Using comprehensive geriatric assessment is not suggested for the sole purpose of decreasing mortality rate or institutionalization in older people referred to general practice and primary care clinics | Weak in against |
| R1b.1 | Using comprehensive geriatric assessment, through the multidimensional prognostic index (MPI) and the Resident Assessment Instrument for Home Care (RAI-HC), is suggested to predict the short-, medium- and long-term risk of death in older people referred to general practice and primary care clinics | Weak in favor |
| R2a.1 | Using comprehensive geriatric assessment is suggested to reduce mortality rate in older people referred to specialist medical clinics | Weak in favor |
| R2a.2 | Using comprehensive geriatric assessment is not suggested for the sole purpose of reducing hospitalization and institutionalization rate in older people referred to specialist medical clinics | Weak in against |
| R2a.3 | Using comprehensive geriatric assessment is suggested to increase the appropriateness of prescribing (discontinuation of chemotherapy due to toxic effects) in older people referred to specialist medical clinics | Weak in favor |
| R2b.1 | Using comprehensive geriatric assessment, through the multidimensional prognostic index, is suggested to predict the risk of death in older people with cancer and referred to specialist clinics in the medical area | Weak in favor |
| R3a.1 | Using comprehensive geriatric assessment is suggested to reduce the length of stay in older people referred to specialist surgical outpatient clinics | Weak in favor |
| R3a.2 | Using comprehensive geriatric assessment is suggested to reduce the incidence of post-operative delirium in older people referred to specialist surgical outpatient clinics | Weak in favor |
| R3b.1 | Using comprehensive geriatric assessment, through the multidimensional prognostic index, is suggested to predict post-operative complications in older people with colorectal cancer referred to specialist surgical outpatient clinics | Weak in favor |
| R4a.1 | Using comprehensive geriatric assessment is suggested to reduce hospitalization rate in older people admitted to the emergency department | Weak in favor |
| R4a.2 | Using comprehensive geriatric assessment is suggested to reduce functional impairment, over a period of 4 to 12 months, in older people admitted to the emergency department | Weak in favor |
| R4a.3 | Using comprehensive geriatric assessment is suggested to reduce readmission rates to the emergency department within two weeks to 12 months after the first access, in older people admitted to the emergency department | Weak in favor |
| R5a.1 | Using comprehensive geriatric assessment is recommended to reduce institutionalization rate in older people admitted to hospital medical wards | Strong in favor |
| R5a.2 | Using comprehensive geriatric assessment is not recommended for the sole purpose of reducing mortality or re-hospitalization rate in older people admitted to hospital medical wards | Strong in against |
| R5b.1 | Using comprehensive geriatric assessment, through the multidimensional prognostic index (MPI), is suggested to predict the risk of short- (< 1 month), medium- (6 months) and long-term (12 months) mortality in older people admitted to hospital medical wards | Weak in favor |
| R5b.2 | Using comprehensive geriatric assessment, through a CGA-based Predictive Score (DAMAGE study), is suggested to predict the risk of death at 12 months, and, through the HOPE Index (Hospitalized Older Patient Examination) and the Mortality Risk Index (MRI) at 24 months, in older people admitted to hospital medical wards | Weak in favor |
| R5b.3 | Using comprehensive geriatric assessment, through the multidimensional prognostic index (MPI), is suggested to predict the risk of institutionalization in older people admitted to hospital medical wards | Weak in favor |
| R5b.4 | Using comprehensive geriatric assessment, through the HOPE Index, is recommended to predict the risk of re-hospitalization at 24 months in older people admitted to hospital medical wards | Strong in favor |
| R5b.5 | Using comprehensive geriatric assessment, through the multidimensional prognostic index (MPI), is suggested to predict the risk of prolonged hospital stay in older people admitted to hospital medical wards | Weak in favor |
| R5b.6 | Using comprehensive geriatric assessment, through the multidimensional prognostic index (MPI), is suggested to identify older people admitted to hospital medical wards that are at a higher risk of delirium | Weak in favor |
| R6a.1 | Using comprehensive geriatric assessment is recommended to reduce the incidence of delirium in older people admitted to orthogeriatric wards and referred to surgical wards | Strong in favor |
| R6a.2 | Using comprehensive geriatric assessment is not recommended for the sole purpose of reducing mortality or institutionalization rates in nursing homes or re-hospitalization rate in older people admitted to orthogeriatric and in surgical hospital wards | Strong in against |
| R7a.1 | Using comprehensive geriatric assessment is not recommended for the sole purpose of reducing mortality rate in older people admitted to long-term care rehabilitation facilities | Strong in against |
| R8a.1 | Using comprehensive geriatric assessment is not suggested for the sole purpose of reducing mortality or hospitalization rates in older people resident in nursing homes | Weak in against |