Observational studyJournal of the American College of Surgeons2015
Quality of Care Delivered Before vs After a Quality-Improvement Intervention for Acute Geriatric Trauma.
Observational study in Journal of the American College of Surgeons, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Configurations and outcomes of acute hospital care for frail and older patients with moderate to major trauma: a systematic review.BMJ open · 2023Pooled it
- Identifying Age-Specific Risk Factors for Poor Outcomes After Trauma With Machine Learning.The Journal of surgical research · 2024Article
- Trauma Registry: Trauma Quality indicators analysis in hospitalized patients.Revista do Colegio Brasileiro de Cirurgioes · 2024Article
- Complications in low-risk older adult trauma patients: A case-control study.The journal of trauma and acute care surgery · 2019Article
- Trauma in the Elderly: Demographic Trends (1995-2014) in a Major New Zealand Trauma Centre.World journal of surgery · 2019Article
- Early geriatric consultation increases adherence to TQIP Geriatric Trauma Management Guidelines.The Journal of surgical research · 2017Article
- Sustainability of a proactive geriatric trauma consultation service.Canadian journal of surgery. Journal canadien de chirurgie · 2017Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundOlder trauma-injury patients had improved recovery after we implemented routine geriatric consultation for patients aged 65 years and older admitted to the trauma service of a Level I academic trauma center. The intervention aimed to improve quality of geriatric care. However, the specific care processes that improved are unknown. STUDY
designWe conducted a prospective observation comparing medical care after (December 2007 to November 2009) vs before (December 2006 to November 2007) implementation of the geriatric consult-based intervention. To measure quality of care (QOC), we used 33 previously validated care-process quality indicators (QIs) from the Assessing the Care of Vulnerable Elders (ACOVE) study, measured by review of medical records for 76 geriatric consult (GC) vs 71 control group patients. As prespecified subgroup analyses, we aggregated QIs by type: geriatric (eg, delirium screening) vs nongeriatric condition-based care (eg, thrombosis prophylaxis) and compared QI scores by type of care. Last, we aggregated QI scores into overall, geriatric, and nongeriatric QOC scores for each patient (number of QIs passed/number of QIs eligible), and compared patient-level QOC for the GC vs control group, adjusting for age, sex, ethnicity, comorbidity, and injury severity.
resultsSixty-three percent of the GC patients vs 11% of the control group patients received a geriatric consultation. We evaluated 2,505 QIs overall (1,664 geriatric type and 841 nongeriatric QIs). In general, fewer geriatric-type QIs were passed than nongeriatric QIs (71% vs 81%; p < 0.001). We provided better overall QOC to the GC (77%) than control group patients (73%; p < 0.05). However, the difference was not statistically significant after multivariable adjustment (p = 0.08). We improved geriatric QOC for the GC (74%) compared with the control group (68%; p < 0.01), a difference that was significant after multivariable adjustment (p = 0.01).
conclusionsGeriatricians and surgeons can collaboratively improve geriatric QOC for older trauma patients.
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