Evidence map›Paper›PMID 33888071›Full record

SynthesisBMC anesthesiology2021

Effects of comprehensive geriatric care models on postoperative outcomes in geriatric surgical patients: a systematic review and meta-analysis.

Aparna Saripella, Sara Wasef, Mahesh Nagappa, Sheila Riazi, Marina Englesakis, Jean Wong, Frances Chung

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC anesthesiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 4 pooled it
6.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 56 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Geriatric Models of Surgical Care: A Scoping Review.Journal of advanced nursing · 2026
    Article
  7. Review
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  9. Article
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  11. Article
  12. Review
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  14. Factors associated with frailty and the effect of frailty on postoperative outcomes in older adults with hip fracture.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2025
    Article
  15. Article
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  19. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Aparna SaripellaDepartment of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst St, Toronto, ON, M5T2S8, Canada.
Sara WasefDepartment of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst St, Toronto, ON, M5T2S8, Canada.
Mahesh NagappaDepartment of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Sheila RiaziDepartment of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst St, Toronto, ON, M5T2S8, Canada.
Marina EnglesakisLibrary and Information Services, University Health Network, Toronto, ON, Canada.
Jean WongDepartment of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst St, Toronto, ON, M5T2S8, Canada.
Frances ChungDepartment of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst St, Toronto, ON, M5T2S8, Canada. frances.chung@uhn.ca.ORCID 0000-0001-9576-3606
University Health Network · CAWestern University · CA

Funding

University Health Network Foundation, and Department Of Anesthesia and Pain Medicine, University Health Network, University of Toronto 585225462760
6 · The paper itself

Abstract

backgroundThe elderly population is highly susceptible to develop post-operative complications after major surgeries. It is not clear whether the comprehensive geriatric care models are effective in reducing adverse events. The objective of this systematic review and meta-analysis is to determine whether the comprehensive geriatric care models improved clinical outcomes, particularly in decreasing the prevalence of delirium and length of hospital stay (LOS) in elderly surgical patients.

methodWe searched Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Emcare Nursing, Web of Science, Scopus, CINAHL, ClinicalTrials. Gov, and ICTRP between 2009 to January 23, 2020. We included studies on geriatric care models in elderly patients (≥60 years) undergoing elective, non-cardiac high-risk surgery. The outcomes were the prevalence of delirium, LOS, rates of 30-days readmission, and 30-days mortality. We used the Cochrane Review Manager Version 5.3. to estimate the pooled Odds Ratio (OR) and Mean Difference (MD) using random effect model analysis.

resultsEleven studies were included with 2672 patients [Randomized Controlled Trials (RCTs): 4; Non-Randomized Controlled Trials (Non-RCTs): 7]. Data pooled from six studies showed that there was no significant difference in the prevalence of delirium between the intervention and control groups: 13.8% vs 15.9% (OR: 0.76; 95% CI: 0.30-1.96; p = 0.57). Similarly, there were no significant differences in the LOS (MD: -0.55; 95% CI: - 2.28, 1.18; p = 0.53), 30-day readmission (12.1% vs. 14.3%; OR: 1.09; 95% CI: 0.67-1.77; p = 0.73), and 30-day mortality (3.2% vs. 2.1%; OR: 1.34; 95% CI: 0.66-2.69; p = 0.42). The quality of evidence was very low.

conclusionsThe geriatric care models involved pre-operative comprehensive geriatric assessment, and intervention tools to address cognition, frailty, and functional status. In non-cardiac high-risk surgeries, these care models did not show any significant difference in the prevalence of delirium, LOS, 30-days readmission rates, and 30-day mortality in geriatric patients. Further RCTs are warranted to evaluate these models on the postoperative outcomes.

trial registrationPROSPERO registration number - CRD42020181779 .

Indexed as

GeriatricsAgedEmergence DeliriumHumansLength of StayPatient ReadmissionPostoperative ComplicationsAdverse outcomesComprehensive geriatric assessmentComprehensive geriatric care modelDeliriumElderlySurgery

Identifiers

PMID33888071
PMCPMC8061210
OpenAlexW3154134138

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.