Table 2.
Summary of primary outcomes reported in 13 included studies comparing CGA to standard care
| Primary outcome | |||||||
| Author, year | Surgery | No of participants | Description | Time point | Outcome of intervention group | Outcome of control group | Findings |
| Emergency Surgery | |||||||
| Kennie 198831 | Hip fracture | 108 | Physical independence- Katz index categories B-D | At hospital discharge | 75.6% | 46.2% | Favours intervention p=0.005 |
| Marcantonio 200132 | Hip fracture | 126 | Total cumulative incidence of delirium during hospital stay (MMSE, DSI, MDAS, CAM) | During admission | 32% | 50% | No difference p=0.4 |
| Huusko 200216 | Hip fracture | 260 | Length of stay | After successful discharge from any hospital for 2 weeks | 34 days (95% CI 28 to 38) | 42 days (95%CI35-48) | No difference p=0.05 |
| Naglie 200233 | Hip fracture | 280 | Proportion of patients alive with no decline in ambulation or transfers in and out of a chair or bed and no change in place of residence | 6 months after surgery | 39.7% | 34.1% | No difference Difference 5.6%–95% 95% CI 5.6% to 17% |
| 36Vidan 2005 | Hip fracture | 321 | Length of stay | Discharge | 16 days | 18 days | Favours intervention p=0.06 |
| Lundstrom 200721 | Hip fracture | 199 | No of days of postoperative delirium (DSM-IV criteria) | In-hospital | 5.0±7.1 | 10.2±13.3 | Favours intervention p=0.009 |
| Deschodt 201129 | Hip fracture | 171 | Function status (6-item Katz Index) | In-hospital | Multiple time points reported | Multiple time points reported | No difference, except if measured on day 8 |
| Taraldsen 201423 | Hip fracture | 397 | Mobility (short physical performance battery) | 4 months | 5.2 (SE0.20) | 4.38 (SE0.2) | Favours intervention Difference 0.74 (95%CI 0.18 to 1.30) p=0.010 |
| Watne 201437 | Hip fracture | 329 | Cognitive performance (10 words test, CERAD battery, CDR scale, sum of boxes score) | 4 months | 54.7 | 52.9 | No difference 95% CI −5.9 to 9.5 p=0.65 |
| Shyu 2016* | Hip fracture | 299 | Self care ability (recovery of IADL) | Up to 24 months | not reported | not reported | Favours intervention p<0.05 |
| Elective surgery | |||||||
| Hempenius 201330 | Surgery for solid tumour | 297 | Delirium | Up to 10 days postoperatively | 9.4% | 14.3% | No difference OR6.3 95%CI0.29–1.35 |
| Partridge 201735 | AAA repair or lower-limb arterial bypass | 209 | Length of stay | Discharge | 3.32 | 5.53 | Favours intervention Difference 0.6 (95%CI0.46–0.79) p<0.001 |
| Ommundsen 201834 | Resection colon/rectal cancer | 122 | Number of patients with Clavien-Dindo grade II–V postoperative complications | 30 days | 68% | 75% | No difference p=0.43 |
*Note Shyu et al was a three group comparison trial.
AAA, abdominal aortic aneurysm; CAM, confusion assessment method; CDR, clinical dementia rating; CERAD, Consortium to Establish a Registry for Alzheimers Disease; CGA, comprehensive geriatric assessment; DSI, delirium symptom interview; DSM-IV, Diagnostic and Statistical Manual of Mental Disorder fourth edition; IADL, instrumental activities of daily living; MDAS, Memorial Delirium Assessment Scale; MMSE, Mini-Mental State Examination.