Frailty, Retrospective Study
Conditions
Brief summary
Acute illness could be enormous stress for frail people. Combining comprehensive geriatric assessment and multifactorial intervention has positive effects on frail community older adults. However, few studies investigated the effects of post-acute care (PAC) in frail older patients who just recovered from acute hospitalization. This study aimed to evaluate the effects of PAC on frail older adults in Taiwan.
Detailed description
Frail patients aged \>= 75 were recruited and divided into PAC or control groups. The PAC group received comprehensive geriatric assessment (CGA) and multifactorial intervention for two to four weeks. The control group received CGA only. The primary outcomes were 90-day emergency room visits, readmissions, and mortality after PAC.
Interventions
OTHERPost-acute care
A personalized care program, focusing on managing geriatric syndromes and improving functional performances. Strength training, activities of daily living (ADL) and instrumental activities of daily living (IADL) practice, basic mobility training, reconditioning exercise, and home environment assessment and modification.
Sponsors
Taipei City Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
75 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Mild to severe frailty identified by the Clinical Frailty Scale 2. Age ≥ 75 years 3. Diagnosis with Parkinson's disease, dementia, chronic obstructive pulmonary disease, or chronic kidney disease stage three or worse 4. Acute hospital stays between 3 to 30 days with deconditioning 5. Stable medical condition with no need of intensive care, laboratory examination, or oxygen dependence
Exclusion criteria
1. Refused to participate in the program 2. Candidate for other post-acute care programs (i.e. stroke, traumatic neurological injury, or fracture) 3. Unable to cooperate with the program due to mental or cognitive impairment 4. Long-term ventilator-dependence 5. Long-term bed-ridden status (\> 6 months) 6. Diagnosed as end of life and in need of palliative care 7. Diagnosed as major illness (i.e. end-stage renal disease) and in need of frequent inpatient treatment ( \> 3 times over recent 6 months) 8. Institutional residents 9. Home medical care participants
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 90-day emergency room visits | 90 days after post-acute care | Emergency room visits after post-acute care |
| 90-day readmissions | 90 days after post-acute care | Readmissions visits after post-acute care |
| 90-day mortality | 90 days after post-acute care | Mortality after post-acute care |
Countries
Taiwan
Outcome results
None listed