European Geriatric Medicine - Supplement 1 - Volume 7 - October 2016

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mortality, readmission rate and number of patients discharged
home. High risk of bias was observed across studies and outcomes
downgrading the level of evidence. Clinical heterogeneity between
interventions was observed leading to question how geriatric
co-management programs should be organized to affect clinical
outcomes.
Conclusions: Geriatric co-management reduces length of stay,
number of patients with complications, and improves functional
status. Cluster randomized trials with process evaluation are needed to
further support implementation.
P-247
Impact of functional status and cognition in outcome of older
patients admitted in an internal medicineward at 6 and 12 months
follow-up
M. Maia1, S. Duque2,3, M.J. Serpa1, Y. Mamade1, A. Watts Soares1,
Á. Chipepo 1, S. Velho4, F. Araújo1, J. Pimenta da Graça1. 1Internal
Medicine Department, Hospital Beatriz Ângelo, Loures, 2Internal Medicine
Department, Centro Hospitalar de Lisboa Ocidental – Hospital São
Francisco Xavier, 3Unidade Universitária de Geriatria – Faculdade de
Medicina – Universidade de Lisboa, Lisboa, 4Nutrition and Dietetics
Department, Hospital Beatriz Ângelo, Loures, Portugal
Introduction: Previous studies have revealed that age alone is not the
best outcome predictor in elderly. Instead, other prognostic factors
have been identified, such as the functional and cognitive status. Our
aim was to analyze outcomes at 6 and 12 months (6 and 12 M) of a
cohort of patients ≥75 years admitted in an Internal Medicine Ward
according baseline functional and cognitive status.
Methods: Prospective longitudinal cohort study of 100 patients.
Comprehensive geriatric assessment (CGA) at baseline. Survival and
hospital readmission at 6 and 12 M assessed by phone contact and
hospital record analysis.
Results: One patient lost during follow-up. Average age 83.7 years, 63%
males, average Cumulative Illness Rating Scale Geriatrics 11.2, average
baseline Barthel score (BS) 63.6 ± 35.3. Concerning the baseline
cognitive status: normal cognition 68%, mild cognitive impairment
12%, dementia 20%. Cumulative mortality: 6 M 48.4%, 12 M 53.5%.
Average BS of survivors vs non-survivors: at 6 M – 74.4 ± 24.8 vs
52.3 ± 41.3, p 0.004; at 12 M – 75.3 ± 23.4 vs 53.24 ± 40.9, p 0.005.
Mortality at 6 and 12 M was significantly higher in patients with
cognitive impairment. Kaplan-Meier survival curves supported impact
of BS and cognition in mortality at 6 and 12 M. BS and cognition were
not associated to emergency department readmission and hospital-
ization at 6 and 12 M.
Conclusion: Functional and Cognitive status are important predictors
of survival in hospitalized elderly. Medical decisions should be based
not only in age but also on previous functional and cognitive status.
Such data are useful to combat ageism and to highlight the importance
of systematic CGA.
P-248
Frailty in older patients with cancer: agreement of three
assessment tools
Y. Duval1,2, O. Bouche3, M. Donet2, Y. Jaidi 2, J.L. Novella2,4,
R. Mahmoudi 1,2,4. 1UCOG Champagne-Ardenne, Reims, 2Service de
Médecine interne et gériatrie, CHU de Reims, 3Unité de Médecine
Ambulatoire, CHU de Reims, 4EA3797 Faculté de Médecine de Reims,
France
Introduction: Assessment of Frailty by a Comprehensive Geriatric
Assessment (CGA) [1] is a key point for older patients with cancer.
However, the other assessment tools are poorly or not described in the
oncogeriatric context. The aim of this study was to evaluate the
agreement of three Frailty assessment tools in older patients with
cancer.
Methods: Our study was a cross-sectional study with forward-looking
inclusions. It was conducted in the Reims teaching hospital (geriatrics
and oncology ward). We included patients of 65 or more years old with
cancer. Frailty was assessed with three different tools: CGA, Fried
criteria [2] and Rockwood’s Clinical Frailty Scale (CFS) [3].
Results: One hundred patients were included (Mean age: 77.8 ± 6.7
years). 54 patients were females and 94 patients were living at home.
73 patients were affected by a digestive cancer. Forty-five patients
were at a metastatic stage of their disease. According to the CGA: 6
patients were fit, 40 pre-frail and 54 frail. According to the Fried
criteria: 24 patients were fit, 42 prefrail and 34 frail. According to the
CFS: 42 patients were fit, 35 prefrail and 23 frail. Agreement between
CGA and Fried criteria was poor (κ = 0.36, CI95% – [0.24;0.49]).
Agreement between CGA and CFS was poor too (κ = 0.27, CI95% –
[0.17;0.37]). Agreement between CFS and Fried criteria was moderate
(κ = 0.53, CI95% – [0.41;0.64]).
Conclusion: There is a lack of agreement between these three
assessment tools in oncogeriatric context.
References
[1] Wildiers H, Heeren P, Puts M, Topinkova E, Janssen-Heijnen MLG,
Extermann M, et al. International Society of Geriatric Oncology
consensus on geriatric assessment in older patients with cancer.
J Clin Oncol Off J Am Soc Clin Oncol. 2014;32(24):2595– 603.
[2] Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C,
Gottdiener J, et al.Frailty in older adults: evidence for a phenotype.
J Gerontol A Biol Sci Med Sci. 2001;56(3):M146– 56.
[3] Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB,
McDowell I, et al. A global clinical measure of fitness and frailty
in elderly people. CMAJ Can Med Assoc J J Assoc Medicale Can.
2005;173(5):489–95.
P-249
Predictive abilities of three frailty assessment tools in
oncogeriatrics concerning one-year overall survival
Y. Duval1,2, J.L. Novella2,3, M. Donet2, Y. Jaidi2, O. Bouche4,
R. Mahmoudi1,2,3. 1UCOG Champagne-Ardenne, Reims, 2Service de
Médecine interne et gériatrie, CHU de Reims, 3EA3797 Faculté de
Médecine de Reims, 4Unité de Médecine Ambulatoire, CHU de Reims,
France
Introduction: Consequences of frailty in elderly with cancer are
well known, particularly with overall survival. In this population,
Comprehensive Geriatric Assessment (CGA) is mainly used to define
Frailty [1]. The aim of this study was to evaluate predictive capabilities
of three different assessment tools in oncogeriatrics.
Methods: Our study was a cross-sectional study with forward-looking
inclusions. It was conducted in the Reims teaching hospital (geriatrics
and oncology ward). We included patients of 65 or more years old
with cancer. Frailty was assessed with three different tools: CGA, Fried
criteria [2] and Rockwood’ s Clinical Frailty Scale (CFS) [3]. We have
studied survival using a Log-Rank test.
Results: One hundred patients were included. Mean age was 77.8
years, 54 patients were females and 94 patients were living at home.
73 patients were affected by a digestive cancer. Forty-five patients
were at a metastatic stage of their disease. According to the CGA: 46
patients were not frail and 54 frail. According to the Fried criteria: 66
patients were not frail and 34 frail. According to the CFS: 77 patients
were not frail and 23 frail. Only Frailty according Fried criteria was
significantly predictive of one-year survival: χ2 = 4.6 (p = 0.031).
Results for CGA and CFS were not significant, with respectively 3.7
(p = 0.059) and 3.5 (p = 0.06).
Conclusion: According to our study, Fried criteria seem to have better
predictive capabilities concerning one-year overall survival in onco-
geriatrics than CGA or CFS.
References
[1] Handforth C, Clegg A, Young C, Simpkins S, Seymour MT, Selby
PJ, et al. The prevalence and outcomes of frailty in older cancer
patients: a systematic review. Ann Oncol Off J Eur Soc Med Oncol
ESMO. 2015;26(6):1091–101.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S94