Does special assessment of older people getting surgery improve their recovery after surgery?

New
Authors: 
Eamer G, Taheri A, Chen SS, Daviduck Q, Chambers T, Shi X, Khadaroo RG

What is the aim of this review?

Our aim was to find out whether an assessment, called comprehensive geriatric assessment (CGA), of people who are aged 65 years and over improves how well they do after surgery. CGA involves several healthcare professionals and addresses the medical illness, physical decline and social factors that slow recovery.

Key messages

We found that older people with hip fracture who received CGA were less likely to die and more likely to return home. There were not enough high quality studies in other patient groups to determine if CGA is useful for them.

What was studied in the review?

The world's population is getting older; more and more people are now over the age of 65 years and are at increased risk of complications after surgery, which include infection, heart attacks and even death. CGA is known to lower complications in hospitalized older people, but no reviews looked specifically into older people who have had surgery. We conducted this review to address that gap. We compared people who received CGA either before (2 studies) or after surgery (6 studies) to people who received traditional postoperative care from their surgeon.

What are the main results of the review?

We included eight studies conducted in North America and Europe. Seven studies recruited people with broken hips (1583 participants) and one involved people who had cancers removed (260 participants).

We found that older people who received CGA probably have lower risk of dying, and that after discharge, were more likely to return to the same location they lived in before hospital admission. Older people who received the intervention probably stayed in hospital for fewer days, although we cannot be sure by how long, because results from studies varied too much. Both those who received the intervention, and those who did not, were re-admitted to hospital a similar number of times. It probably costs a bit less to provide care when older people receive CGA. As for complications after surgery, the results from the different studies varied a lot so we cannot be sure whether CGA causes more complications.

How up-to-date is this review?

We last searched for new studies on 13 January 2017.

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