Identification of Factors Affecting the Increased Percentage of CGA Recommendations among Patients on Geriatric Ward

Justyna Gołębiowska, Małgorzata Szymala-Pędzik, Joanna Żórawska, Małgorzata Sobieszczańska and Siddarth Agrawal ()
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Justyna Gołębiowska: Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland
Małgorzata Szymala-Pędzik: Clinical Department of Geriatrics, Wroclaw Medical University, Pasteur 4 Street, 50-367 Wroclaw, Poland
Joanna Żórawska: Clinical Department of Geriatrics, Wroclaw Medical University, Pasteur 4 Street, 50-367 Wroclaw, Poland
Małgorzata Sobieszczańska: Clinical Department of Geriatrics, Wroclaw Medical University, Pasteur 4 Street, 50-367 Wroclaw, Poland
Siddarth Agrawal: Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland

IJERPH, 2023, vol. 20, issue 3, 1-12

Abstract: In Poland, the elderly population is noticeably increasing every year. Therefore, the current healthcare system has to rise to the challenge of treatment and prevention strategies targeting elderly persons. Based on the Vulnerable Elders Survey (VES-13 scale), consisting of international and validated scales, we put effort into identifying the factors affecting the increased percentage of CGA (Comprehensive Geriatric Assessment) recommendations by healthcare system physicians. The study group involved 78 patients from the Department of Geriatrics, Wroclaw Medical University, Poland, aged 60–91 (median Me = 81 years old). Of the studied patients, 51 were recommended for CGA (51/78; 64.6%). A statistically significant association was observed between CGA recommendation and age ( p < 0.001); the likelihood of a CGA recommendation increased with age. Furthermore, the increased CGA recommendation was observed among geriatric patients with: (a) frailty syndrome (OR = 11.2, CI95% 2.88–43.5, p < 0.001), (b) high risk of malnutrition or malnutrition (OR = 3.87; CI95%, 1.00–14.9, p = 0.04), (c) low mental status (OR = 3.32, CI95% 1.22–9.09, p = 0.029), (d) low ability to perform basic daily duties (according to ADL scale—OR = 12.6, CI95% 1.57–101, p = 0.004 and IADL scale—OR = 4.71, CI95% 1.72–12.9, p = 0.003), and (e) fall risk (OR = 15.0, CI95% 4.67–48.3, p < 0.001). Moreover, homocysteine levels increased with age ( p = 0.003) and decreased with sleep duration ( p = 0.043). Taken together, all these factors seem to be important when implementing treatment programs adjusted to the individual geriatric patient.

Keywords: geriatric assessment; CGA recommendation; frailty syndrome; factors of CGA recommendation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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