Evidence map›Paper›PMID 28031704›Full record

Trial reportClinical interventions in aging2017

Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care?

Niklas Ekerstad, Björn W Karlson, Synneve Dahlin Ivanoff, Sten Landahl, David Andersson, Emelie Heintz, Magnus Husberg, Jenny Alwin

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical interventions in aging, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Pooled it
  2. Exercise for acutely hospitalised older medical patients.The Cochrane database of systematic reviews · 2022
    Pooled it
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  8. Trial
  9. Review
  10. Article
  11. Review
  12. Models of Care for Older People: A Scoping Review.Journal of the American Geriatrics Society · 2025
    Article
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  14. Observational
  15. Observational
  16. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Niklas EkerstadDepartment of Cardiology, NU (NÄL-Uddevalla) Hospital Group, Trollhattan; Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping.
Björn W KarlsonDepartment of Molecular and Clinical Medicine, Institute of Medicine.
Synneve Dahlin IvanoffCentre for Ageing and Health, AGECAP, Department of Health and Rehabilitation.
Sten LandahlDepartment of Geriatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg.
David AnderssonDivision of Economics, Department of Management and Engineering, Linköping University, Linköping.
Emelie HeintzHealth Outcomes and Economic Evaluation Research Group, Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
Magnus HusbergDivision of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping.
Jenny AlwinDivision of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of this study was to investigate whether the acute care of frail elderly patients in a comprehensive geriatric assessment (CGA) unit is superior to the care in a conventional acute medical care unit.

designThis is a clinical, prospective, randomized, controlled, one-center intervention study.

settingThis study was conducted in a large county hospital in western Sweden.

participantsThe study included 408 frail elderly patients, aged ≥75 years, in need of acute in-hospital treatment. The patients were allocated to the intervention group (n=206) or control group (n=202). Mean age of the patients was 85.7 years, and 56% were female.

interventionThis organizational form of care is characterized by a structured, systematic interdisciplinary CGA-based care at an acute elderly care unit. MEASUREMENTS: The primary outcome was the change in health-related quality of life (HRQoL) 3 months after discharge from hospital, measured by the Health Utilities Index-3 (HUI-3). Secondary outcomes were all-cause mortality, rehospitalizations, and hospital care costs.

resultsAfter adjustment by regression analysis, patients in the intervention group were less likely to present with decline in HRQoL after 3 months for the following dimensions: vision (odds ratio [OR] =0.33, 95% confidence interval [CI] =0.14-0.79), ambulation (OR =0.19, 95% CI =0.1-0.37), dexterity (OR =0.38, 95% CI =0.19-0.75), emotion (OR =0.43, 95% CI =0.22-0.84), cognition (OR = 0.076, 95% CI =0.033-0.18) and pain (OR =0.28, 95% CI =0.15-0.50). Treatment in a CGA unit was independently associated with lower 3-month mortality adjusted by Cox regression analysis (hazard ratio [HR] =0.55, 95% CI =0.32-0.96), and the two groups did not differ significantly in terms of hospital care costs (

conclusionPatients in an acute CGA unit were less likely to present with decline in HRQoL after 3 months, and the care in a CGA unit was also independently associated with lower mortality, at no higher cost.

Indexed as

Frail ElderlyHospital AdministrationQuality of LifeAgedAged, 80 and overCognitionFemaleGeriatric AssessmentHealth Services for the AgedHumansMaleOdds RatioPatient DischargeProportional Hazards ModelsProspective StudiesSwedenacute carecomprehensive geriatric assessmentelderlyfrailtyintervention

Identifiers

PMID28031704
PMCPMC5179210

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.