Eighteen studies (9,096 participants) were included: eight were randomised controlled trials, four were prospective cohorts with retrospective controls, and six were retrospective chart reviews. Ten studies evaluated routine geriatric consultation, three evaluated geriatric wards and five evaluated shared care on orthopaedic wards. Seven studies were rated good quality and 11 were rated fair quality.
Compared with usual care, multidisciplinary care significantly reduced in-hospital mortality by 40% (RR 0.60, 95% CI 0.43 to 0.84; Ι²=28%) and long-term mortality by 17% (RR 0.83, 95% CI 0.74 to 0.94; Ι²=0). There was a small but statistically significant difference in length of stay (SMD -0.25, 95% CI -0.44 to -0.05; Ι²=96%).
Routine geriatric consultation significantly reduced in-hospital (RR 0.51, 95% CI 0.38 to 0.69; Ι²=0) and long-term (RR 0.78, 95% CI 0.65 to 0.95; Ι²=0) mortality, but not length of stay. Data for the other two models were limited (details in the paper).
Evidence of possible publication bias was found for length of stay.