Geriatric Assessment and Intervention for Older Patients With Frailty in the Emergency Department

Not Applicable

Completed

• Conditions: Hospital Readmission; Quality of Life; Patient Admission; Frail Elderly Syndrome; Fall; Length of Stay
• Interventions: Other: CGA

• Registration Number: NCT03751319
• Lead Sponsor: Helsinki University Central Hospital

Brief Summary

Comprehensive Geriatric Assessment (CGA) is an established approach for better detection of frailty-related problems and includes individualized treatment plan with multi-discipline supportive and treating measures for the older frailty patients. However, there is limited evidence of feasibility and efficacy of the CGA when provided in the emergency department setting.

In the GAOPS-study the efficacy of the CGA in emergency department setting will be studied by randomized controlled study protocol. We aim to study if the CGA provided in the ED is feasible, safe and efficient method when added with standard emergency care for older frail patients.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2018-11-18
• Study First Submitted QC: 2018-11-21
• Study First Posted: 2018-11-23
• Study Start: 2018-12-11
• Primary Completion: 2020-06-07
• Study Completion: 2021-07-02
• Status Verified: 2021-08
• Last Update Submitted: 2021-08-04
• Last Update Posted: 2021-08-11

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 432

Inclusion Criteria

• Age of minimum 75 years
• "Clinical Frailty Scale" minimum 4 estimated at the arrival to the ED by nurse

Exclusion Criteria

• Non-resident of the counties (City of Espoo, Kirkkonummi, Kauniainen) of the hospital district.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Standard Emergency Care + CGA	CGA	Standard Care is provided for the acute condition as usual by the ED personnel. Besides the standard care provided by ED personnel, patients are systemically screened and assessed by physician trained for geriatrics or geriatric emergency medicine. Geriatric multi-discipline treatment plan and recommendations are given if suitable for the case.

Primary Outcome Measures

Name	Time	Method
Cumulated Length of Stay	Day 365	Cumulated stay (days) in hospital wards (university hospital and community hospital) including all admissions during the follow-up.

Secondary Outcome Measures

Name	Time	Method
Admissions	Day 30, Day 365	Number of admissions to the hospital wards (university hospital and community hospital) during the follow-up.
Admission rate	Day 0	Proportion of admitted patients (university hospital or community hospital ward) from the index ED-visits.
Readmissions in the ED	Hour 72, Day 30, Day 365	Re-visits to the ED after the index-visit.
Living at home	Day 365	Proportion of the patients living at home.
Quality of Life	Day 0, Day 365	Change of the quality of life during one year follow-up using the standardized questionnaire EuroQol EQ-5D-5L. Measured value is the index value defined by the EuroQol group.

Trial Locations

Locations (1)

Helsinki University Hospital, Jorvi ED; 🇫🇮 Espoo, Uusimaa, Finland