title: A systematic review of comprehensive geriatric assessment to improve outcomes for frail older people being rapidly discharged from acute hospital: 'interface geriatrics'.
abstract: BACKGROUND
  many frail older people who attend acute hospital settings and who are discharged home within short periods (up to 72 h) have poor outcomes. This review assessed the role of comprehensive geriatric assessment (CGA) for such people.
  
  
  METHODS
  standard bibliographic databases were searched for high-quality randomised controlled trials (RCTs) of CGA in this setting. When appropriate, intervention effects were presented as rate ratios with 95% confidence intervals.
  
  
  RESULTS
  five trials of sufficient quality were included. There was no clear evidence of benefit for CGA interventions in this population in terms of mortality [RR 0.92 (95% CI 0.55-1.52)] or readmissions [RR 0.95 (95% CI 0.83-1.08)] or for subsequent institutionalisation, functional ability, quality-of-life or cognition.
  
  
  CONCLUSIONS
  there is no clear evidence of benefit for CGA interventions in frail older people being discharged from emergency departments or acute medical units. However, few such trials have been carried out and their overall quality was poor. Further well designed trials are justified.
authors: University of Leicester School of Medicine, Leicester Royal Infirmary, UK. spc3@le.ac.uk
authors: Simon Paul
authors: SP
authors: Conroy
authors: Tony
authors: T
authors: Stevens
authors: Stuart G
authors: SG
authors: Parker
authors: John R F
authors: JR
authors: Gladman