A Pilot Study of the Effects on an Inpatient Geriatric Consultation Team on Geriatric Syndrome Patients

Song-Seng Loke,1 Chien-Te Lee,2 Shan Huang,3 Chao-Tung Chen4 1Division of Geriatric Medicine, Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan; 2Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan; 3Department of Management, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan; 4Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, TaiwanCorrespondence: Song-Seng Loke, Division of Geriatric Medicine, Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Dapi Road, Niaosong District, Kaohsiung City, 833, Taiwan, Tel +886-7-7317123, Email loke@cgmh.org.twPurpose: To evaluate the effect of comprehensive geriatric assessment performed by an inpatient aging consultation team on older patients with geriatric syndromes.Methods: Fifty-nine patients with ≧65 years, Barthel Index score ≦60, at least one geriatric syndrome, and admitted to non-geriatric wards were enrolled. By their preference, 16 were in the intervention group with comprehensive geriatric assessment and instructions from the consultation team. And 43 were in the control group, receiving standard care from non-geriatric-specialist physicians. Outcomes were readmission and mortality within one year after discharge.Results: The mean age of the intervention and control groups was 78.35 (8.54) and 80.23 (6.36) years (p = 0.36), with female of 62.5% and 60.5%, respectively. Compared to control, intervention is not significantly associated with attenuated risk for readmission (adjusted hazard ratio (aHR): 0.256, 95% confidence interval (CI): 0.12– 1.78, p = 0.256) and mortality (aHR: 2.13, 95% CI: 0.29– 15.7, p = 0.457) within one year after discharge. Multivariate analysis showed that patients with a fall history ≧1 in the past one year had a lower risk of readmission (aHR: 0.28, 0.07– 0.6, p = 0.004) or mortality (aHR: 0.11, 95% CI: 0.01– 0.97, p = 0.047), and disability is associated with mortality (aHR: 5.37, 95% CI: 0.87– 33.12, p = 0.07).Conclusion: Intervention is not significantly associated with outcomes in our pilot study. But fall history ≧1 in the recent one year is associated with a lower risk of readmission and mortality among all included patients. More participants and longer follow-up are needed for better elucidation.Keywords: comprehensive geriatric assessment, inpatient geriatric consultation team, geriatric syndrome, readmission rate, mortality rate