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Meta-Analysis
. 2020 Mar;88(3):446-453.
doi: 10.1097/TA.0000000000002571.

A systematic review and meta-analysis evaluating geriatric consultation on older trauma patients

Debra Eagles  1 , Bradley Godwin, Wei Cheng, Joy Moors, Sonshire Figueira, Lara Khoury, Karine Fournier, Jacinthe Lampron
Affiliations
Meta-Analysis

A systematic review and meta-analysis evaluating geriatric consultation on older trauma patients

Debra Eagles et al. J Trauma Acute Care Surg. 2020 Mar.

Abstract

Background: Early involvement of geriatrics is recommended for older trauma patients.

Objective: This systematic review aimed to determine the impact of a geriatric assessment on mortality, hospital length of stay, discharge destination, and delirium incidence in patients 65 years and older admitted to a trauma center.

Methods: The protocol was developed according to Preferred Reporting Items for Systematic Review and Meta-analysis guidelines and registered in PROSPERO (CRD42019131870). Search of five databases was completed April 2019. Two independent reviewers completed screening, full text review, and data abstraction. Meta-analysis was performed on outcomes with at least two studies.

Results: A total of 928 unique citations were identified; eight were included in the final analysis. All were cohort studies, most of moderate to poor quality using the Newcastle-Ottawa Scale. We found hospital length of stay decreased by mean of 1.11 days (95% confidence interval, 0.79-1.43), but mortality was unchanged (odds ratio, 1.01; 95% confidence interval, 0.74-1.38) in older patients admitted to a trauma center who had a geriatric consultation. Meta-analysis of discharge destination and delirium incidence was not performed due to heterogeneity.

Conclusions: This is the first systematic review and meta-analysis to evaluate outcomes in older patients admitted to a trauma center after implementation of a geriatric trauma consultation service. We found a decrease in hospital length of stay but insufficient evidence of change in in-hospital mortality in older patients who received a geriatric consultation as part of their trauma care compared with those that received standard trauma care only. There is a need for more methodologically rigorous research in geriatric trauma.

Level of evidence: Systematic review and meta-analysis, level III.

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