Cochrane · systematic review · CD010569
Enhanced rehabilitation and care models for adults with dementia following hip fracture surgery
Smith, TO, Gilbert, AW, Sreekanta, A, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Dementia and Cognitive ImprovementAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
25
current version
GRADE rated
14
No studies
11
Included studies
NR
No studies 11 · 44%Ungraded 0 · 0%Very low 13 · 52%Low 1 · 4%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Interdisciplinary enhanced rehabilitation (inpatient rehabilitation) compared to conventional rehabilitation for adults with dementia following hip fracture surgery
Population: adults with dementia following hip fracture surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Health‐related quality of life Interdisciplinary enhanced rehabilitation (inpatient rehabilitation) vs conventional rehabilitation | no estimate extracted | NR | No studies |
Activities of daily living and functional performance (personal ADL independence at 12 months Interdisciplinary enhanced rehabilitation (inpatient rehabilitation) vs conventional rehabilitation | OR 4.62 [0.18, 119.63] | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision |
Activities of daily living and functional performance (walking independently without an aid or assistance at 12‐month Interdisciplinary enhanced rehabilitation (inpatient rehabilitation) vs conventional rehabilitation | OR 7.2 [0.74, 70.42] | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision |
Cognitive function Interdisciplinary enhanced rehabilitation (inpatient rehabilitation) vs conventional rehabilitation | no estimate extracted | NR | No studies |
Behaviour Interdisciplinary enhanced rehabilitation (inpatient rehabilitation) vs conventional rehabilitation | no estimate extracted | NR | No studies |
Pain Interdisciplinary enhanced rehabilitation (inpatient rehabilitation) vs conventional rehabilitation | no estimate extracted | NR | No studies |
Mortality (during hospitalisation) Interdisciplinary enhanced rehabilitation (inpatient rehabilitation) vs conventional rehabilitation | OR 0.6 [0.17, 2.13] | 3 studies · 152 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events (postoperative delirium during hospitalisation) Interdisciplinary enhanced rehabilitation (inpatient rehabilitation) vs conventional rehabilitation | OR 0.04 [0.01, 0.22] | 2 studies · 141 participants | Low Downgraded: risk of bias, imprecision |
Interdisciplinary enhanced rehabilitation (inpatient and community rehabilitation) compared to conventional rehabilitation for adults with dementia following hip fracture surgery
Population: adults with dementia following hip fracture surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Health‐related quality of life Interdisciplinary enhanced rehabilitation (inpatient and community rehabilitation) vs conventional rehabilitation | no estimate extracted | NR | No studies |
Activities of daily living and functional performance (Chinese Barthel Index (0‐to‐100‐point scale where higher scores indicate greater functional performance at 12 months) Interdisciplinary enhanced rehabilitation (inpatient and community rehabilitation) vs conventional rehabilitation | no estimate extracted | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Activities of daily living and functional performance (pre‐fracture walking levels at 12 months) Interdisciplinary enhanced rehabilitation (inpatient and community rehabilitation) vs conventional rehabilitation | OR 58.33 [3.04, 1118.19] | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Cognitive function Interdisciplinary enhanced rehabilitation (inpatient and community rehabilitation) vs conventional rehabilitation | no estimate extracted | NR | No studies |
Behaviour Interdisciplinary enhanced rehabilitation (inpatient and community rehabilitation) vs conventional rehabilitation | no estimate extracted | NR | No studies |
Pain Interdisciplinary enhanced rehabilitation (inpatient and community rehabilitation) vs conventional rehabilitation | no estimate extracted | NR | No studies |
Mortality at 12 months post‐hip fracture Interdisciplinary enhanced rehabilitation (inpatient and community rehabilitation) vs conventional rehabilitation | OR 1.07 [0.47, 2.45] | 2 studies · 177 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events (incidence of falls at 12 months) Interdisciplinary enhanced rehabilitation (inpatient and community rehabilitation) vs conventional rehabilitation | OR 0.2 [0.01, 4.47] | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Geriatrician‐led inpatient management compared to orthopaedic‐led inpatient management for adults with dementia following hip fracture surgery
Population: adults with dementia following hip fracture surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Health‐related quality of life Geriatrician‐led inpatient management vs orthopaedic‐led inpatient management | no estimate extracted | NR | No studies |
Activities of daily living and functional performance (activities of daily living capabilities assessed using BADLS at 12 months) BADLS (0 to 60 points; higher scores equate to poorer functional performance) Geriatrician‐led inpatient management vs orthopaedic‐led inpatient management | no estimate extracted | 1 study · 87 participants | Very low Downgraded: risk of bias, imprecision |
Activities of daily living and functional performance (NEADL score at 12 months) NEADL (0 to 22 points, where higher scores equate to greater functional performance) Geriatrician‐led inpatient management vs orthopaedic‐led inpatient management | no estimate extracted | 1 study · 87 participants | Very low Downgraded: risk of bias, imprecision |
Activities of daily living and functional performance (functional performance measured using the SPPB at 12 months) SPPB (0 to 12 points, where higher scores equate to greater functional performance) Geriatrician‐led inpatient management vs orthopaedic‐led inpatient management | no estimate extracted | 1 study · 87 participants | Very low Downgraded: risk of bias, imprecision |
Cognitive function (cognitive function measured using the IQCODE at 12 months) IQCODE (1 to 5 points, where higher scores equate to poorer cognitive function) Geriatrician‐led inpatient management vs orthopaedic‐led inpatient management | no estimate extracted | 1 study · 87 participants | Very low Downgraded: risk of bias, imprecision |
Behaviour Geriatrician‐led inpatient management vs orthopaedic‐led inpatient management | no estimate extracted | NR | No studies |
Pain Geriatrician‐led inpatient management vs orthopaedic‐led inpatient management | no estimate extracted | NR | No studies |
Mortality at 12 months Geriatrician‐led inpatient management vs orthopaedic‐led inpatient management | OR 2 [0.74, 5.36] | 1 study · 87 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events (delirium during hospitalisation) Geriatrician‐led inpatient management vs orthopaedic‐led inpatient management | OR 0.94 [0.52, 1.72] | 2 studies · 212 participants | Very low Downgraded: risk of bias, imprecision |