study | Intervention /control condition | Primary Outcome-Frailty | Secondary outcomes | Significance |
---|---|---|---|---|
[29] | CGA unit (N = 206) |  | At baseline: - Physical fitness, mean ± SD: HS: 18.8 ± 7.2; 6-MWT: 146 ± 103.4; TUG: 30 ± 23.2 - Number of Hospital days: 11.2 At follow up vs baseline: - Physical fitness, mean (95% CI) a: HS: + 1.64 (0.93–2.36); 6-MWT: + 21.4 (5.8–37); TUG: + 6.75 (4.03–9.45) - Decline in physical fitness, n(%), [OR (95% CI)]: HS: 23 (17.2), [3.2 (1.7–6.1)] a; 6-MWT: 9 (10.8), [7.0 (2.8–17.7)] a; TUG: 18 (17.1), [2.8 (1.3–5.9)] a Number of hospital days per patient, mean: 16.2 | Between group changes: - change in physical fitness a HS p < 0.001 6-MWT p < 0.001 TUG p = 0.042 - Number of hospital days: p = 0.002 |
Conventional acute care (N = 202) |  | At baseline, mean ± SD: - Physical fitness: HS: 18 ± 7.9; 6-MWT: 160 ± 100; TUG: 37.4 ± 28.6 - Number of Hospital days: 9.2 At follow up vs baseline: - Physical fitness, mean (95% CI) a: HS: − 0.9 (− 1.7 to − 0.1); 6-MWT:: --60.7 (− 80.6 to − 40.9); TUG: + 2.19 (− 1.15 to 5.45) - Decline in physical fitness, n(%): HS: 46 (42.6); 6-MWT: 26 (50); TUG: 26 (37.1) Number of Hospital days, mean: 16.9 | ||
[32] | CGA unit (N = 72) |  | Follow up, n (%): - Getting help from doctors with medical problems: Great help, fairy great help: 62 (86.1); Little and very little help: 10 (13.9) - Getting nursing from ward staff that you needed: Yes always, yes often: 66 (98.5); No not often, no seldom: 1 (1.5) - Satisfied with received information: Very satisfied, fairy satisfied: 64 (90.1); Fairy unsatisfied: 7 (9.1) Satisfied with planning before discharge: Very satisfied, fairy satisfied: 64 (89); Fairy unsatisfied: 8 (11) | Between group changes: - Getting nursing that you needed p = 0.003 - Satisfied with received information p = 0.016 Satisfied with planning before discharge p = 0.023 |
Conventional acute care (N = 76) |  | Follow up, n (%): - Getting help from doctors with medical problems: Great help, fairy great help: 50 (75.8); Little and very little help: 16 (24.2) - Getting nursing from ward staff that you needed: Yes always, yes often: 55 (83.3); No not often, no seldom: 11 (16.7) - Satisfied with received information: Very satisfied, fairy satisfied: 50 (74.6); Fairy unsatisfied: 17 (25.4) Satisfies with planning before discharge: Very satisfied, fairy satisfied: 48 (74); Fairy unsatisfied: 17 (26) | ||
[31] | CGA unit (N = 206) |  | At baseline - HUI-3, mean: Vision: 0.886; Hearing: 0.815; Speech: 0.999; Ambulation: 0.540; Dexterity: 0.871; Emotion: 0.823; Cognition: 0.896; Pain: 0.621 - EQ-VAS score, mean: 51.1 - Mortality, n (%): 8 (4) At follow-up (1 month) - Rehospitalization, n (%): 40 (19) At follow-up (3 months) - HUI-3, mean: Vision: 0.873; Hearing: 0.818; Speech: 0.995; Ambulation: 0.584; Dexterity: 0.856; Emotion: 0.896; Cognition: 0.933; Pain: 0.766 - Decline in HUI, OR (CI 95%) a: vision: 0.33 (0.14–0.79); ambulation: 0.19 (0.1–0.37); dexterity: 0.38 (0.19–0.75); emotion: 0.43 (0.22–0.84); cognition 0.076 (0.033–0.18); pain: 0.28 (0.15–0.50); hearing: 0.50 (0.22–1.1); speech: 0.45 (0.11–1.9) - EQ-VAS score, mean: 56.8 - Mortality, n (%), [HR (CI 95%)] a: 27 (13), [0.55 (0.32–0.96)] Rehospitalization, n (%): 73 (37) | Between group changes in follow-up: - HUI-3: Ambulation p = 0.001; cognition p < 0.001; pain p < 0.001 - Decline in HRQoL: vision p = 0.013; ambulation p < 0.001, dexterity p = 0.007, emotions p = 0.014, cognition p < 0.001, and pain p < 0.001 - Rehospitalizations: P = 0.048 EQ-VAS score: p = 0.003 |
Conventional acute care (N = 202) |  | At baseline - HUI-3, mean: Vision: 0.884; Hearing: 0.881; Speech: 0.975; Ambulation: 0.569; Dexterity: 0.882; Emotion: 0.865; Cognition: 0.877; Pain: 0.631 - EQ-VAS score, mean: 48.9 - Mortality, n (%): 10 (5) At follow-up (1 month) - Rehospitalization, n (%): 56 (28) At follow-up (3 months) - HUI-3, mean: Vision: 0.862; Hearing: 0.817; Speech: 0.985; Ambulation: 0.458; Dexterity: 0.804; Emotion: 0.896; Cognition: 0.834; Pain: 0.594 - EQ-VAS score, mean: 51.2 Rehospitalization, n (%): 88 (46) | ||
[22] | CGA unit (N = 206) | At follow up vs baseline: Increase in degree of frailty, assessed with FRESH screening tool, n (%), [OR (95% CI)]: 24 (13.6), [0.229 (0.131–0.400)] | At follow up vs baseline - Average change of ADL Staircase, mean ± SD: 0.2 ± 1.1 to up - Decline in ADLs staircase, n (%), [OR (95% CI)]: 24 (14.1), [0.093 (0.052–0.16)] a - Decline in ADL stratum, n(%): 11 (6.3) Increase in use of municipal services, n(%), [OR (95% CI)]: 36 (20), [0.682 (0.395–1.178)] a | Between group changes: - Increase in degree of frailty p < 0.0001 - Decline in ADLs p < 0.0001 Decline in ADL stratum: p = 0.0001 |
Conventional acute care (N = 202) | At follow up vs baseline: Increase in degree of frailty, assessed with FRESH screening tool, n (%): 66 (41) | At follow up vs baseline: - Average change of ADL Staircase, mean ± SD:1.1 ± 1.6 to down - Decline in ADL staircase, n(%): 98 (63.6) - Decline in ADL stratum, n(%): 33 (20.2) Increase in use of municipal services, n(%): 44 (26.2) | ||
[21] | APEP group (n = 17) | Baseline: - Frailty index, mean ± SD: 0.46 ± 0.20 Follow up, mean ± SD, [mean (95% CI)]: Frailty index: 0.40 ± 0.19, [0.01 (−0.02 to 0.05)] a | Baseline: - Mobility, mean ± SD: DEMMI: 49.4 ± 16.0; HABAM: 19.1 ± 4.7; TUG: 28.6 ± 13.2; Gait Speed: 0.53 ± 0.17 - 6-MWT, mean ± SD: 154.5 ± 59.6 - FES-1, Median (IQR): 31 (22–57) - FAC, Median (IQR): 4 (3–4) Follow up Mobility, mean ± SD, [mean (95% CI)]: DEMMI: 57.2 ± 17, [4.1 (0.4 to 7.8)] a; HABAM: 20.3 ± 4.9, [0 (− 0.9 to 0.9)] a; TUG: 22.8 ± 12.2, [2.5 (0.4 to 4.6)]a; Gait Speed: 0.65 ± 0.20, [0.07 (0.01 to 0.13)]a 6-MWT, mean ± SD, [mean (95% CI)]: 194.9 ± 85.8, [34.7 (13.7 to 55.7)] a FES-1, median (IQR), [mean (95% CI)]: 30 (22–52), [24 (−5.5 to 10.3)]a FAC, median (IQR), [mean (95% CI)]: 4 (4–4), [0 (− 0.4 to 0.4)] a Length of stay, mean ± SD: 18.4 ± 2.3 Adherence rate, mean ± SD: 78 ± 26% |  |
Usual care (n = 18) | Baseline: - Frailty index, mean ± SD: 0.46 ± 0.14 Follow up: Frailty index, mean ± SD: 0.41 ± 0.15 | Baseline: - Mobility, mean ± SD: DEMMI: 52.9 ± 11.1; HABAM: 19.9 ± 4.4; TUG: 24.9 ± 11.1; Gait Speed: 0.60 ± 0.19 - 6-MWT, mean ± SD: 167.7 ± 79.4 - FES-1, Median (IQR): 31 (26–45) - FAC, Median (IQR): 4 (3–4) Follow up, mean (SD): - Mobility, mean ± SD: DEMMI: 55.7 ± 11.3; HABAM: 20.9 ± 4.0; TUG: 22.4 ± 9.5; Gait Speed: 0.64 ± 0.28 - 6-MWT, mean ± SD: 170.8 ± 79.9 - FES-1, Median (IQR): 31 (25–46) - FAC, Median (IQR): 4 (3–4) Length of stay, mean ± SD: 17.8 ± 4.2 | ||
[11] | mHELP group (n = 197) | At follow up, n (%), [RR (95% CI)] - Incident frailty, assessed with Fried’s criteria, during stays in hospital: 20 (12), [0.55 (0.33–0.93)] Persistent frailty: 6 (50), [0.54 (0.30–0.97)] | Follow up Changes on body weight, mean ± SD: − 2.1 ± 5.5 | Between group changes: - Incident frailty during stays p = 0.02 - Persistent frailty p = 0.03 Changes on body weight: p = 0.002 |
Usual care (n = 180) | At follow up, n (%): - Incident frailty, assessed with Fried’s criteria, during stays in hospital: 30 (21.7) Persistent frailty: 13 (92.9) | Follow up Changes on body weight, mean ± SD: − 4.0 ± 3.4 | ||
[30] | mHELP group, n = 107 | At discharge - Transitions between Fried’s frailty states of pre-frail: advanced to frail: 18%; pre-frail: 64%; non frail: 18% - Rate of frailty using Fried’s criteria, n(%), [OR (95% CI)] b: 10.52 (19.2), [0.1 (0.02–0.39)] Follow up - Rate of frailty according to Fried’s criteria, n(%), [OR (95% CI)] b: 9.52 (17.3), [0.73 (0.21–2.56)] Improved to not frail according to Fried’s criteria: 21% | Follow up: Length of hospital stay (days), mean ± SD: 20.5 ± 18.2 | Between group changes: - Difference in Transitions between frailty states, p < 0.001 Frailty rate at discharge; p = 0.001 |
Usual care, n = 82 | At discharge - Transitions between Fried’s frailty states of pre-frail: advanced to frail: 68%; remaining in a pre-frail: 32% - Rate of frailty using Fried’s criteria, n(%): 34.52 (65.4) b Follow up - Rate of frailty according to Fried’s criteria, n(%): 12.52 (23.1)b Improved to not frail according to Fried’s criteria: 9% | Follow up: Length of hospital stay (days), mean ± SD: 17.3 ± 11.0 |