Impact of geriatric co-management on outcomes in hospitalised cardiology patients aged 85and over.

Abstract

Cardiovascular disease and frailty are common among the population aged85+. We hypothesised these patients might benefit from geriatric co-management, as has been shown in other frail patient populations. However, there is limited evidence supporting geriatric co-management in older, hospitalised cardiology patients. Aretrospective cohort study was performed in alarge teaching hospital in the Netherlands. We compared patients aged85 and over admitted to the cardiology ward before (control group) and after the implementation of standard geriatric co-management (intervention group). Data on readmission, mortality, length of stay, number of consultations, delirium, and falls were analysed. The data of 1163 patients were analysed (n = 542 control, n = 621 intervention). In the intervention group, 251 patients did not receive the intervention because of logistic reasons or the treating physician's decision. Baseline characteristics were comparable in the intervention and control groups. Patients in the intervention group had ashorter length of stay (-1day, p = 0.01) and were more often discharged to ageriatric rehabilitation facility (odds ratio [OR] 1.97, 95% confidence interval [CI] 1.10-3.54, p = 0.02) compared with the control patients. Other outcomes were not significantly different between the groups. After implementation of standard geriatric co-management for hospitalised cardiology patients aged85 and over, the length of hospital stay shortened and the number of patients discharged to ageriatric rehabilitation facility increased. The adherence to geriatric team recommendations was high. Geriatric co-management would appear to optimise care for older hospitalised patients with cardiac disease.