Effects of comprehensive geriatric care on depressive symptoms, emergency department visits, re-hospitalization and discharge to the same residence in older persons receiving hip-fracture surgery: A meta-analysis.

Abstract

The aim of this study was to evaluate depressive symptoms, emergency department visits, re-hospitalization and discharge to the same residence of comprehensive geriatric care in patients receiving hip-fracture surgery. Hip fractures among older persons result in restricted activities of daily living, longer hospital stays, frequent emergency department visits and re-presentation to hospital, which may increase depressive symptoms and death risk. The benefits of comprehensive geriatric care have not been determined. A five-step Cochrane collaboration meta-analysis was used. Randomized controlled trials published from 1980 to 2020 in which comprehensive geriatric care was provided following hip-fracture surgery were retrieved from the Cochrane Library, Clinical Key, Embase, MEDLINE, OVID and PubMed databases. Indicators were depressive symptoms, emergency department visits, re-hospitalization and discharge to the same residence. The Group Reading Assessment, Risk of Bias 2.0 tool, modified Jadad scale and Comprehensive Meta-Analysis Version 3 software were used. Overall, 1291 patients from six randomised controlled trials were included. Comprehensive geriatric care improved depressive symptoms and lowered emergency department visits but did not improve re-hospitalization rates or discharge to the same residence. Comprehensive geriatric care should include depression management and individualized care plans. Further depression-related studies are required to verify their benefits.