Effect of geriatric care on health outcomes in older patients with cardiac disease: A systematic review

Abstract

Background: As patients with cardiac disease age and become frail, their care needs become more complex. Therefore geriatric care might benefit these patients. This review summarizes current research investigating the impact of geriatric care on clinical outcomes in older cardiac patients. Methods: The MEDLINE, Embase, and Cochrane databases were searched on 11 May 2023 for randomized controlled trials (RCTs) and observational studies comparing additional geriatric care to usual care in older (+70) cardiac patients. The Cochrane risk of bias tool and Robbins-E tool were used for quality assessment of RCTs and observational studies respectively. Data on mortality rates, readmissions, length of stay, complications, discharge destinations, functional outcomes, and quality of life (QoL) were extracted. Two authors independently selected studies, extracted data and assess study quality. Results: Twelve articles involving 3531 patients (average age 73–85 years; 44–59 % male) were identified, mainly focussing on heart failure or patients requiring cardiothoracic surgery. The studies had a moderate to high risk of bias. Two out of three studies (n = 771) showed reduced complication rates (e.g. delirium incidence) when comparing geriatric assessment to usual care. Additionally, two out of three studies (n = 449), indicated improved QoL scores for patients who received a geriatric care. No significant effects were found for other outcomes. Conclusion: Low-quality evidence suggests that geriatric care may be associated with lower complication rates and an improved quality of life in older cardiac patients. However, more research is needed to clarify the effect of a geriatric care in this patient population.