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The yield of utilization of comprehensive geriatric assessment (CGA) among older patients admitted at St. Luke's Medical Center.

Author

Ramona S. Pungutan,
Miguel A. Ramos

Related Institution

Section of Geriatric Medicine, - St. Luke's Medical Center, Quezon City, Metro Manila, Philippines

Publication Information

Publication Type
Journal
Sub Type
Journal Article, Original
Title
Philippine Journal of Internal Medicine
Date of Publication
January-February 2006
Volume
44
Issue
1
Page(s)
1-5
Notes
ISSN 0119-9641

Abstract

BACKGROUND: In the advent of the growing aging population, much health care services and clinical research has sought to define the healthcare delivery modalities and specific interventions that would address specific problems in the elderly. The complete geriatric assessment has been central to the approach since it contains the traditional medical history and incorporates additional information assessing geriatric specific issues. Comprehensive geriatric assessment (CGA) is defined as a multidimensional medical, functional, psychosocial and environmental evaluation of an older person's problems and resources, linked with an overall plan for treatment and follow-up. In the clinical context, CQA is used to identify functional problems and disabilities of older patients with the aim of providing care and arranging longer-term follow-up.

OBJECTIVES: This study was conducted to determine the yield of utilizing the complete geriatric assessment (CQA) as a diagnostic screening tool in the hospital setting and to identify the geriatric syndromes that are commonly missed with the use of traditional medical history and physical examination.

METHODOLOGY: This is a prospective study involving 40 patients admitted at St. Luke's Medical Center from January 2005 to January 2006. All 40 patients were interviewed and examined by the Geriatric medicine fellow using the CQA on admission and was compared with traditional medical history, physical exam and diagnosis of admitting medical resident and confirmed by attending consultant.

RESULTS: The use of CQA yielded identification of mild cognitive impairment (5 percent), cases of malnutrition (7 percent), depression (20 percent), polypharmacy (25 percent), deficiencies in vaccination for pneumonia and influenza (30 percent), dementia (37 percent), at risk for fall (40 percent), at risk for malnutrition (40 percent), and impairment in the instrumental and activities of daily living (45 percent).

CONCLUSION: CQA implemented in a specialized geriatric center, St. Luke's Medical Center yields detection of specific geriatric syndromes which are often missed when using a traditional medical history and physical exam.

References

1. Philippine 2000 Census of Population and Housing 2005.
2. Stuck, A E, Aronow, H U, Steiner, A , Alessi, C A. A Trial of annual in-home comprehensive geriatric assessment for elderly people living in the communityThe New England Journal of Medicine 232, 1104, 1995
3. Rubenstein, L Z, Goodwin, C H. Working Group Recommendations: Targeting criteria for geriatric evaluation and management researchJournal American Geriatric Society 39, 37S, 1991
4. Rubenstein, L Z, Stuck, A E, Siu, A L, Wieland, D . Impacts of geriatric evaluation and management programs on defined outcomes: Overview ofJournal American Geriatric Society 39, 8S, 1991
5. Rubenstien, L Z, Josephson, K R, Wieland, G D, English, P A, Sayre, J A, Kane, R L. Effectiveness of geriatric evaluation unit. A Randomized clinical trialThe New England Journal of Medicine 311, 1664, 1984
6. Mattews, D A. Dr. Marjory Warren and the origins of British geriatricsJournal American Geriatric Society 32, 253, 1984
7. Rubinstein, L Z, Stuck, A E, Siu, A L, Weiland, D . Impacts of geriatric evaluation and management programs on defined outcomes: Overview of evidenceJournal American Geriatric Society (39S): 1991
8. Warren, M W. Care of the chronic aged sickThe Lancet 1, 841, 1946
9. Essentials of Clinical Geriatrics, Eds (Kane, RL, Ouslander JG, Sbras, IB) New York: McGraw-Hill, 1984. 35.
10. Soloon, David , Brown, Sue , Brummel-Smith, Kenneth , et al, . Best paper of the 1980JAGS 51, 1490, 2003
11. Kane, R L, Kane, R A. Assessing Older Persons: Measures, meaning and practical Application New York: Oxford University Press, 2000.
12. Gallo, J J, Fulmer, T , Paveza, G J. Handbook of Geriatric Assessment, 3rd Edition Gaithersburg, Md: Aspen, 2000.
13. Rubenstein, L Z. An Overview of comprehensive geriatric assessment: Rationale, history, program, models, basic components. In: Rubenstein LZ, Wieland D, Bernabei R eds. Geriatric Assessment Technology New York: Springer, 1995.
14. Wieland, Darryl , Hirth, Victor . Comprehensive geriatric assessmentCancer Control 10(6): December 2003
15. Stuck, A E, Siu, A L, Wieland, G D, Adams, J , Rubenstein, L Z. Comprehensive geriatric assessment: Meta-analysis of controlled trialsThe Lancet 342, 1032, 1993
16. Multi dimensional geriatric assessment in the acute hospital and ambulatory practice. Zentrum Geriatric RehabilitationZieglerspital Bern 127(43): October 1997
17. Applegate, W B. The Medical evaluation. In: Rubenstein LZ, Wieland D, Bernnabei, eds. Geriatric Assessment Technology: The State of the Art New York: Springer, 1995.
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