| Methods |
‐ RCT comparing an acute geriatric ward (AGW) with 2 usual care general medical wards (MW).
‐ randomisation in blocks of 12 patients
‐ Setting: Sweden, acute care and tertiary referral hospital.
‐ Funding: Vasterbotten County Council and Vardalstiftelsen and King Gustaf V's and Queen Victoria's Foundation. |
| Participants |
‐ 444 older medical patients (190 AGW and 223 MW). 25 were excluded due to protocol violations.
‐ Mean age 81 years, 60% female and 16% resided in an institution prior to admission.
‐ Inclusion criteria: patients older than 70 years, acutely admitted to hospital for a medical ailment.
‐ Exclusion criteria: Admission to a specialised unit (intensive care, coronary care, acute stroke unit) or admission to a designated subspecialty unit.
‐ Main presenting symptom: chest pain (23%), dyspnoea (18%), other pain (11%), nausea/vomiting (11%), vertigo (11%), other (26%). |
| Interventions |
‐ Acute geriatric based ward differed from the standard ward in that it provided a geriatrician, physiotherapist, occupational therapist. Interdisciplinary team work focussed on early and intensive rehabilitation and intense discharge planning.
‐ Exercise: Early start to rehabilitation. Physiotherapy and occupational therapy assessment and staffing of the ward to optimise early rehabilitation. |
| Outcomes |
‐ Functional status (Barthel Index), cognitive status (MMSE), psychological well being, mortality, place of residence, length and cost of hospital stay, hospital readmission, healthcare costs, events after discharge, outpatient visits and personal assistance requirements.
‐ Time of outcome measure assessment: hospital discharge and 3 months after hospital discharge. |
| Notes |
‐ Language: English
‐ PEDro score: 6
‐ Cost data converted from SEK to US$ using the conversion rates reported
by the author.
‐ Author conclusions: " A geriatric approach with greater emphasis on early rehabilitation and discharge planning in the AGW shortened the length of hospital stay and may have reduced the need for long‐term institutional living." |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment? |
Low risk |
A ‐ Adequate |
