Abstract
Comprehensive geriatric assessment is an established clinical approach. It reduces mortality and improves the physical
wellbeing of older people in the community or hospitalised for medical reasons. Pre-operative comprehensive
geriatric assessment seems a plausible method for reducing adverse postoperative outcomes. The objectives of this
systematic review and narrative synthesis are to describe how pre-operative comprehensive geriatric assessment has
been used in surgical patients and to examine the impact of comprehensive geriatric assessment on postoperative
outcomes in older patients undergoing scheduled surgery. We searched MEDLINE, EMBASE and Web of Science
from 1980 to 2013 (week 26). We included five studies: two randomised controlled trials and three before-and-after
intervention quasi-experimental studies. Patient populations, interventions and outcome measures varied between
studies. Both the randomised trials showed benefit on postoperative outcomes, including medical complications. Two
of the before-and-after studies reported a positive impact on postoperative length of stay and other outcomes. The
heterogeneity of study methods, populations, interventions and outcomes precluded meta-analysis. Based on this
narrative synthesis, pre-operative comprehensive geriatric assessment is likely to have a positive impact on postoperative
outcomes in older patients undergoing elective surgery, but further definitive research is required. Clinical
services providing pre-operative comprehensive geriatric assessment for older surgical patients should be considered.
wellbeing of older people in the community or hospitalised for medical reasons. Pre-operative comprehensive
geriatric assessment seems a plausible method for reducing adverse postoperative outcomes. The objectives of this
systematic review and narrative synthesis are to describe how pre-operative comprehensive geriatric assessment has
been used in surgical patients and to examine the impact of comprehensive geriatric assessment on postoperative
outcomes in older patients undergoing scheduled surgery. We searched MEDLINE, EMBASE and Web of Science
from 1980 to 2013 (week 26). We included five studies: two randomised controlled trials and three before-and-after
intervention quasi-experimental studies. Patient populations, interventions and outcome measures varied between
studies. Both the randomised trials showed benefit on postoperative outcomes, including medical complications. Two
of the before-and-after studies reported a positive impact on postoperative length of stay and other outcomes. The
heterogeneity of study methods, populations, interventions and outcomes precluded meta-analysis. Based on this
narrative synthesis, pre-operative comprehensive geriatric assessment is likely to have a positive impact on postoperative
outcomes in older patients undergoing elective surgery, but further definitive research is required. Clinical
services providing pre-operative comprehensive geriatric assessment for older surgical patients should be considered.
| Original language | English |
|---|---|
| Pages (from-to) | 8-16 |
| Number of pages | 9 |
| Journal | Anaesthesia |
| Volume | 16 |
| Publication status | Published - 2014 |