{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T12:23:29Z","timestamp":1790511809486,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004497","name":"Onderzoeksraad, KU Leuven","doi-asserted-by":"publisher","award":["REF22\/15\/028"],"award-info":[{"award-number":["REF22\/15\/028"]}],"id":[{"id":"10.13039\/501100004497","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>Older patients admitted to cardiac care units often suffer functional decline. We evaluated whether a nurse\u2010led geriatric co\u2010management program leads to better functional status at hospital discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A quasi\u2010experimental before\u2010and\u2010after study was performed between September 2016 and December 2018, with the main endpoint at hospital discharge and follow\u2010up at 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Two cardiac care units of the University Hospitals Leuven.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>One hundred and fifty\u2010one intervention and 158 control patients aged 75\u2009years or older admitted for acute cardiovascular disease or transcatheter aortic valve implantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>A nurse from the geriatrics department performed a comprehensive geriatric assessment within 24\u2009h of admission. The cardiac care team and geriatrics nurse drafted an interdisciplinary care plan, focusing on early rehabilitation, discharge planning, promoting physical activity, and preventing geriatric syndromes. The geriatrics nurse provided daily follow\u2010up and coached the cardiac team. A geriatrician co\u2010managed patients with complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS<\/jats:title>\n                    <jats:p>The primary outcome was functional status measured using the Katz Index for independence in activities of daily living (ADL; one\u2010point difference was considered clinically relevant). Secondary outcomes included the incidence of ADL decline and complications, length of stay, unplanned readmissions, survival, and quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The mean age of patients was 85\u2009years. Intervention patients had better functional status at hospital discharge (8.9, 95% CI\u00a0=\u00a08.7\u20139.3 versus 9.5, 95% CI\u00a0=\u00a09.2\u20139.9;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.019) and experienced 18% less functional decline during hospitalization (25% vs. 43%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.006). The intervention group experienced significantly fewer cases of delirium and obstipation during hospitalization, and significantly fewer nosocomial infections. At 6\u2010month follow\u2010up, patients had significantly better functional status and quality of life. There were no differences regarding length of stay, readmissions, or survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>This first nurse\u2010led geriatric co\u2010management program for frail patients on cardiac care units was not effective in improving functional status, but significantly improved secondary outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.17093","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T16:15:50Z","timestamp":1615997750000},"page":"1377-1387","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Geriatric c\n                    <scp>o\u2010management<\/scp>\n                    for cardiology patients in the hospital: A quasi\u2010experimental 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