Effect of geriatric care on health outcomes in older patients with cardiac disease: A systematic review

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics Pub Date : 2025-02-17 DOI:10.1016/j.archger.2025.105786

Renee C.M.A. Raijmann , Terésa N. van Dalen , Huiberdina L. Koek , Manon G. van der Meer , Marielle H. Emmelot-Vonk , Carolina J.P.W. Keijsers

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引用次数: 0

Abstract

Background

As patients with cardiac disease age and become frail, their care needs become more complex. Therefore geriatric care might benefit these patients. This review summarizes current research investigating the impact of geriatric care on clinical outcomes in older cardiac patients.

Methods

The MEDLINE, Embase, and Cochrane databases were searched on 11 May 2023 for randomized controlled trials (RCTs) and observational studies comparing additional geriatric care to usual care in older (+70) cardiac patients. The Cochrane risk of bias tool and Robbins-E tool were used for quality assessment of RCTs and observational studies respectively. Data on mortality rates, readmissions, length of stay, complications, discharge destinations, functional outcomes, and quality of life (QoL) were extracted. Two authors independently selected studies, extracted data and assess study quality.

Results

Twelve articles involving 3531 patients (average age 73–85 years; 44–59 % male) were identified, mainly focussing on heart failure or patients requiring cardiothoracic surgery. The studies had a moderate to high risk of bias. Two out of three studies (n = 771) showed reduced complication rates (e.g. delirium incidence) when comparing geriatric assessment to usual care. Additionally, two out of three studies (n = 449), indicated improved QoL scores for patients who received a geriatric care. No significant effects were found for other outcomes.

Conclusion

Low-quality evidence suggests that geriatric care may be associated with lower complication rates and an improved quality of life in older cardiac patients. However, more research is needed to clarify the effect of a geriatric care in this patient population.

Registration

The study protocol was registered in the international prospective register of systematic reviews (PROSPERO 2022 CRD42022337353)

查看原文本刊更多论文

老年护理对老年心脏病患者健康结局的影响：一项系统综述

随着心脏病患者年龄的增长和身体的虚弱，他们的护理需求变得更加复杂。因此，老年护理可能对这些患者有益。这篇综述总结了目前调查老年护理对老年心脏病患者临床结果影响的研究。方法于2023年5月11日检索MEDLINE、Embase和Cochrane数据库，检索比较老年（70岁以上）心脏病患者额外老年护理与常规护理的随机对照试验（rct）和观察性研究。分别采用Cochrane偏倚风险工具和Robbins-E工具对随机对照试验和观察性研究进行质量评价。提取死亡率、再入院、住院时间、并发症、出院目的地、功能结局和生活质量（QoL）的数据。两位作者独立选择研究，提取数据并评估研究质量。结果12篇文章共纳入3531例患者，平均年龄73 ~ 85岁；44 - 59%男性)，主要集中在心力衰竭或需要心胸手术的患者。这些研究有中度到高度的偏倚风险。三分之二的研究（n = 771）显示，与常规护理相比，老年评估降低了并发症发生率（如谵妄发生率）。此外，三分之二的研究（n = 449）表明，接受老年护理的患者的生活质量评分有所改善。其他结果未发现显著影响。结论低质量的证据表明，老年护理可能与老年心脏病患者并发症发生率降低和生活质量改善有关。然而，需要更多的研究来阐明老年护理对这一患者群体的影响。该研究方案已在国际前瞻性系统评价注册（PROSPERO 2022 CRD42022337353）中注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of gerontology and geriatrics 医学-老年医学

CiteScore

7.30

自引率

5.00%

发文量

198

审稿时长

16 days

期刊介绍： Archives of Gerontology and Geriatrics provides a medium for the publication of papers from the fields of experimental gerontology and clinical and social geriatrics. The principal aim of the journal is to facilitate the exchange of information between specialists in these three fields of gerontological research. Experimental papers dealing with the basic mechanisms of aging at molecular, cellular, tissue or organ levels will be published. Clinical papers will be accepted if they provide sufficiently new information or are of fundamental importance for the knowledge of human aging. Purely descriptive clinical papers will be accepted only if the results permit further interpretation. Papers dealing with anti-aging pharmacological preparations in humans are welcome. Papers on the social aspects of geriatrics will be accepted if they are of general interest regarding the epidemiology of aging and the efficiency and working methods of the social organizations for the health care of the elderly.