Background
Methods
Search strategy
Study selection and exclusion criteria
Data extraction
Study | Outcomes | Evaluation instruments | ||
---|---|---|---|---|
Quality of life (measure time) | Caregiver burden (measure time) | Length of hospital stay (measure time) | ||
Gayton 1987 [28] | √ (Discharge) | |||
Hogan 1987 [29] | √ (Discharge) | |||
Thomas 1993 [30] | √ (Discharge) | |||
Nikolaus 1999 (CGA) [31] | √ (Discharge; at follow up 12 months) | |||
Nikolaus 1999 (CGA + home) [31] | √ (Discharge; at follow up 12 months) | |||
Naglie 2002 [32] | √ (Discharge; at follow up 6 months ǂ) | |||
Shyu 2005 [33] | √ (1 month after discharge ǂ; 3 months after discharge ǂ) | √ (Discharge) | Quality of life: the 36-Item Short Form Health Survey questionnaire(SF-36) ǁ | |
Vidan 2005 [34] | √ (Discharge) | |||
Kircher 2007 [35] | √ (At follow up 3 months; at follow up 12 months) | √ (At follow up 12 months) | Quality of life: Philadelphia Geriatric Centre Morale Scale(PGCMS) | |
Pitkala 2008 [36] | √ (Discharge) | Quality of life: 15D questionnaire | ||
Prestmo 2015 [37] | √ (1 month after surgery; 4 month after surgery; 12 month after surgery) | √ (Discharge) | Quality of life:EQ-5D-3L | |
Partridge 2017* [38] | √ (Discharge ǂ) | |||
Applegate 1990* [39] | √ (12 months after randomisation ǂ) | |||
Karppi 1995 [40] | √ (At follow up 12 months; at follow up 24 months) | |||
Covinsky 1997 [41] | √ (90 days after dischargeǂ) | √ (Discharge) | Caregiver burden: The Robinson Caregiver Strain Index ǁ | |
Asplund 2000 [42] | √ (Discharge) | |||
Counsell 2000 [43] | √ (Discharge) | |||
Cohen 2002(unit) [44] | √ (Discharge; 12 months after randomisation) | Quality of life: the 36-Item Short Form Health Survey questionnaire(SF-36) | ||
Saltvedt 2004 [45] | √ (Discharge; at follow up 6 months) | |||
Ekerstad 2016 [46] | √ (Discharge; at follow up 3 months) | √ (Discharge; at follow up 3 months) | Quality of life: EuroQoL-visual analog scale (EQ-VAS); Health Utilities Index-3 ǁ | |
Silverman 1995 [47] | √ (12 months after randomisation) | Caregiver burden: Family strain scale developed and validated by Morycz; a global burden questionnaire ǁ | ||
Reuben 1999 [48] | √ (At follow up 15 months) | Quality of life: the 36-Item Short Form Health Survey questionnaire(SF-36) | ||
Burns 2000 [49] | √ (At follow up 12 months; at follow up 24 months) | Quality of life: Rand general well-being (GWB) inventory; Center for Epidemiologic Studies-Depression (CES-D) scale ǁ; perceived global life satisfaction (GLS) ǁ | ||
Weuve 2000 [50] | √ (At follow up 12 months) | Caregiver burden: previously developed inventory that consists of 22 equally weighted statements about perception of burden | ||
Cohen 2002(outpatient) [44] | √ (12 months after randomisation) | Quality of life: the 36-Item Short Form Health Survey questionnaire(SF-36) | ||
Ekdahl 2015 [51] | √ (At follow up 12 months; at follow up 24 months) | √ (At follow up 24 months) | Quality of life: EQ-5D-3L | |
Zintchouk 2018* [52] | √ (At follow up 3 months ǂ) number of improvement | √ (At follow up 3 months ǂ) | Quality of life: Depression List (DL) ǁ | |
Counsell 2007 [53] | √ (At follow up 24 months) | √ (At follow up 12 months ǂ; at follow up 24 months ǂ) | Quality of life: the 36-Item Short Form Health Survey questionnaire(SF-36) | |
Fairhall 2015 [54] | √ (At follow up 3 months; at follow up 12 months) | Quality of life: EQ-5D | ||
Edmans 2013 [55] | √ (At follow up 90 days) | Quality of life: EQ-5D; ICEpop CA Pability measure for older people (ICECAP-O) ǁ |
Assessment of risk of bias
Data synthesis and analysis
Results
Selection of studies
Characteristics of included studies
Risk of bias
Results of meta-analysis
Outcomes | Group basis | Subgroup name | Number of analyses (number of studies) | Heterogeneity I2(%) | Effect SMD/MD[95% CI] | P value |
---|---|---|---|---|---|---|
Quality of life level | overall | / | 15 (8) | 49 | 0.12 [0.03, 0.21] | 0.009 |
Intervention model | CGA-team | 6 (3) | 44 | 0.05 [−0.08, 0.18] | 0.46 | |
OAS | 4 (2) | 71 | 0.22 [−0.04, 0.48] | 0.09 | ||
CGA-unit | 2 (1) | 56 | 0.23 [−0.01, 0.46] | 0.06 | ||
HAS | 2 (1) | 21 | 0.17 [−0.04, 0.38] | 0.11 | ||
HHAS | 1 (1) | / | 0.00 [−0.23, 0.23] | 1.00 | ||
Mean age of participants | ≤ 80 years | 4 (2) | 77 | 0.20 [−0.15, 0.55] | 0.26 | |
> 80 years | 11 (6) | 32 | 0.11 [0.02, 0.19] | 0.01 | ||
Outcome measure time | ≤ 3 months | 7 (6) | 48 | 0.16 [0.03, 0.29] | 0.01 | |
3–12 months | 1 (1) | / | 0.02 [−0.19, 0.23] | 0.83 | ||
≥ 12 months | 7 (5) | 57 | 0.10 [−0.06, 0.25] | 0.21 | ||
Evaluation instruments | EQ-5D | 8 (4) | 0 | 0.05 [−0.03, 0.13] | 0.24 | |
15D questionnaire | 1 (1) | / | 0.44 [0.14, 0.74] | 0.004 | ||
PGCMS | 2 (1) | 0 | −0.06 [−0.26, 0.13] | 0.53 | ||
EQ-VAS | 2 (1) | 56 | 0.23 [−0.01, 0.46] | 0.06 | ||
GWB | 2 (1) | 0 | 0.53 [0.24, 0.81] | 0.0003 | ||
Change of quality of life | overall | / | 5 (3) | 5 | 0.24 [0.10, 0.39] | 0.0008 |
SF-36 Change values for physical functioning dimension | overall | / | 5 (4) | 0 | 0.11 [0.05, 0.16] | 0.0002 |
SF-36 Change values for physical limitation dimension | overall | / | 5 (4) | 64 | 0.04 [−0.05, 0.14] | 0.39 |
SF-36 Change values for general health dimension | overall | / | 5 (4) | 0 | 0.10 [0.05, 0.16] | 0.0003 |
SF-36 Change values for body pain dimension | overall | / | 5 (4) | 56 | 0.09 [0.00, 0.18] | 0.04 |
SF-36 Change values for mental health dimension | overall | / | 5 (4) | 22 | 0.13 [0.06, 0.19] | 0.0001 |
SF-36 Change values for emotional limitation dimension | overall | / | 5 (4) | 0 | 0.04 [−0.02, 0.10] | 0.17 |
SF-36 Change values for energy dimension | overall | / | 5 (4) | 65 | 0.15 [0.06, 0.25] | 0.002 |
SF-36 Change values for social activity dimension | overall | / | 5 (4) | 37 | 0.10 [0.02, 0.17] | 0.01 |
Caregiver burden | overall | / | 2 (2) | 35 | −0.56 [−0.97, −0.15] | 0.007 |
Length of hospital stay | overall | / | 22 (17) | 100 | −1.04 [−3.57, 1.49] | 0.42 |
Intervention model | CGA-unit | 9 (6) | 88 | 0.60 [−1.01, 2.22] | 0.46 | |
CGA-team | 12 (10) | 100 | −1.59 [−5.23, 2.05] | 0.39 | ||
OAS | 1 (1) | / | −4.10 [−8.73, 0.53] | 0.08 | ||
Mean age of participants | ≤ 80 years | 8 (7) | 0 | −0.24 [−0.57, 0.09] | 0.16 | |
> 80 years | 14 (10) | 100 | −0.85 [−4.17, 2.48] | 0.62 | ||
Outcome measure time | ≤ 3 months | 15 (14) | 100 | 0.13 [−2.56, 2.82] | 0.93 | |
3–12 months | 1 (1) | / | 3.70 [−3.55, 10.95] | 0.32 | ||
≥ 12 months | 6 (5) | 100 | −5.17 [−12.35, 2.01] | 0.16 |