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Got It, Hide thisFox MT, Persaud M, Maimets I, et al. Effectiveness of acute geriatric unit care using acute care for elders components: a systematic review and meta-analysis. J Am Geriatr Soc. 2012;60:2237-45.
In older people who are hospitalized with an acute illness or injury, does care in an acute geriatric unit help maintain function and reduce complications compared with usual care?
Older people admitted to hospital for an acute (sudden and serious) illness or injury may have complications. They may also lose some of their ability to do some everyday things without help, such as bathe or move about.
Care in special hospital units may reduce complications and help people keep their abilities.
The researchers did a systematic review, searching for studies that were published up to 2012.
They found 10 randomized controlled trials and 3 other studies with 6,839 people (average age 81 years, 62% women).
The key features of the studies were:
Compared with usual care, acute geriatric units:
Acute geriatric units were no different than usual care for deaths or pressure ulcers (bed sores) while in hospital, or readmissions to hospital up to 3 months after discharge.
In older people who are hospitalized with an acute illness or injury, acute geriatric units reduce falls, delirium and loss of function while in hospital compared with usual hospital care.
Outcomes in hospital | Number of trials and people | Rate of events with acute geriatric unit care | Rate of events with usual hospital care | Absolute effect of acute geriatric units |
Falls | 2 trials (749 people) | 3.9% | 7.7% | About 4 fewer people out of 100 fell in hospital |
Delirium | 3 trials (1154 people) | 17% | 23% | About 6 fewer people out of 100 had delirium in hospital |
Loss of function* | 6 trials (4485 people) | 32% | 36% | About 5 fewer people out of 100 had a decline in function in hospital |
Death | 11 trials (6612 people) | 5.9% | 5.8% | No effect† |
Pressure ulcers (bed sores) | 2 trials (749 people) | 4.2% | 8.5% | No effect† |
*Change in ability to do everyday things without help (e.g., eating, bathing, moving about) from before hospital admission until hospital discharge.
†Although the rates for the 2 groups look a little different, the differences were not statistically significant. This means that the differences could simply be due to chance rather than due to the different treatments.