Skip to main content

Table 4 Primary and secondary outcomes of studies

From: The impact of interventions on management of frailty in hospitalized frail older adults: a systematic review and meta-analysis

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
  1. aadjusted analysis, badjusted analysis and matched pairs, HS Handgrip Strength, 6-MWT 6-Mined Walked Test, TUG Timed up-and-go test, HUI-3 Health Utilities Index-3, EQ-VAS EuroQol-visual analog scale, DEMMI De Morton Mobility Index, HABAM Hierarchical assessment of balance, FES- І Falls efficacy, FAC Functional Ambulation Categories