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

Study Overview
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Brief Summary
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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.

Official Title
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Geriatric Assessment and Intervention for Older Patients With Frailty in the Emergency Department. Randomized Controlled Trial

Conditions
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Length of Stay, Fall, Frail Elderly Syndrome, Patient Admission, Hospital Readmission, Quality of Life

Intervention / Treatment
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* Other: CGA


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomized Controlled Trial
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Standard Emergency Care + CGA<br>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. | Other: CGA<br>* Comprehensive Geriatric Assessment<br>|
| No Intervention: Standard Emergency Care<br>Standard Care is provided for the acute condition as usual by the ED personnel. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cumulated Length of Stay | Cumulated stay (days) in hospital wards (university hospital and community hospital) including all admissions during the follow-up. | Day 365 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Admissions | Number of admissions to the hospital wards (university hospital and community hospital) during the follow-up. | Day 30, Day 365 | 
| Admission rate | Proportion of admitted patients (university hospital or community hospital ward) from the index ED-visits. | Day 0 | 
| Readmissions in the ED | Re-visits to the ED after the index-visit. | Hour 72, Day 30, Day 365 | 
| Living at home | Proportion of the patients living at home. | Day 365 | 
| Quality of Life | 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. | Day 0, Day 365 |