Evidence map›Paper›PMID 36810176›Full record

SynthesisBMJ open2023

Configurations and outcomes of acute hospital care for frail and older patients with moderate to major trauma: a systematic review.

Mary Halter, Heather Jarman, Phil Moss, Stefan Tino Kulnik, Desislava Baramova, Lucia Gavalova, Elaine Cole, Robert Crouch, Mark Baxter

Registry-linked trialOpen access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07027241 (Multicomponent Exercise and Nutrition Based Frailty Intervention in Postoperative Hip Fracture Inpatients), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 7% of its field
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.

NCT07027241 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Multicomponent Exercise and Nutrition Based Frailty Intervention in Postoperative Hip Fracture Inpatients

TypeinterventionalSponsorRoyal College of Surgeons, IrelandRan2025 to 2026Enrolled50ConditionsHip Fractures (ICD-10 72.01-72.2), Frailty at Older Adults, Strength Training, Resistance TrainingArmsExercise Intervention, Usual Care, Nutritional Intervention
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
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

9 authors at 5 institutions in 1 country.

Mary HalterFaculty of Health, Social Care and Education, Kingston University and St George's University of London, London, UK maryhalter@kingston.ac.uk.ORCID 0000-0001-6636-0621
Heather JarmanEmergency Department Clinical Research Unit, St George's University Hospitals NHS Foundation Trust, London, UK.ORCID 0000-0002-4820-3291
Phil MossEmergency department, St George's University Hospitals NHS Foundation Trust, London, UK.ORCID 0000-0002-5551-6261
Stefan Tino KulnikFaculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK.ORCID 0000-0001-5419-6713
Desislava BaramovaEmergency Department, St George's University Hospitals NHS Foundation Trust, London, UK.ORCID 0000-0002-8806-4900
Lucia GavalovaFaculty of Health, Social Care and Education, Kingston University and St George's University of London, London, UK.
Elaine ColeTrauma Sciences, Queen Mary University of London, London, UK.
Robert CrouchHealth Sciences, University of Southampton, Southampton, UK.ORCID 0000-0003-3901-084X
Mark BaxterGeriatric Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
St George’s University Hospitals NHS Foundation Trust · GBSt George's, University of London · GBQueen Mary University of London · GBUniversity Hospital Southampton NHS Foundation Trust · GBUniversity of Southampton · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo systematically review research on acute hospital care for frail or older adults experiencing moderate to major trauma.

settingElectronic databases (Medline, Embase, ASSIA, CINAHL Plus, SCOPUS, PsycINFO, EconLit, The Cochrane Library) were searched using index and key words, and reference lists and related articles hand-searched. INCLUDED ARTICLES: Peer-reviewed articles of any study design, published in English, 1999-2020 inclusive, referring to models of care for frail and/or older people in the acute hospital phase of care following traumatic injury defined as either moderate or major (mean or median Injury Severity Score ≥9). Excluded articles reported no empirical findings, were abstracts or literature reviews, or referred to frailty screening alone.

methodsScreening abstracts and full text, and completing data extractions and quality assessments using QualSyst was a blinded parallel process. A narrative synthesis, grouped by intervention type, was undertaken. OUTCOME MEASURES: Any outcomes reported for patients, staff or care system.

results17 603 references were identified and 518 read in full; 22 were included-frailty and major trauma (n=0), frailty and moderate trauma (n=1), older people and major trauma (n=8), moderate or major trauma (n=7) 0r moderate trauma (n=6) . Studies were observational, heterogeneous in intervention and with variable methodological quality.Specific attention given to the care of older and/or frail people with moderate to major trauma in the North American context resulted in improvements to in-hospital processes and clinical outcomes, but highlights a relative paucity of evidence, particularly in relation to the first 48 hours post-injury.

conclusionsThis systematic review supports the need for, and further research into an intervention to address the care of frail and/or older patients with major trauma, and for the careful definition of age and frailty in relation to moderate or major trauma. INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS PROSPERO: CRD42016032895.

Indexed as

FrailtyAgedFrail ElderlyHospitalsHumansPatientsaccident & emergency medicinegeriatric medicinetrauma management

Identifiers

PMID36810176
PMCPMC9944672
OpenAlexW4321452854

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.