105 / 290
interactions. All identified PIPs have been then discussed by the
multidisciplinary geriatric team (MGT) for considering possible revi-
sions. MPI1 and 2 have been puted together for the analysis.
Results:
166 patients were enrolled (mean age 87 ± 5.4 years, females
72%) with a meanMPI score of 0.69, indicative of a very frail population
(MPI3 55.4% of total sample). Average number of drugs at admission
was 5.3 ± 2.4 for MPI1+2 and 6.4 ± 3.1 for MPI3 patients (p < 0.05).
Between admission and discharge the number of detected PIPs
decreased by 6.7% and 49.2% in MPI 1 + 2 and MPI3 respectively.
Conclusions:
The prevalence of polypharmacy and PIPs are higher
in MPI3 subjects and in this group prescriptive appropriateness
improved more effectively after evaluation of MGT. MPI may be useful
to put more focus on patient care.
P-264
Should elderly patients presenting with facial injuries have a
targeted follow-up in place? A service evaluation
T. Noton, M. Baxter, C. Paget, S. Harris, S. Sharma.
University of
Southampton, University Hospital Southampton NHS Foundation Trust
Background:
The proportion of elderly patients over 65 years of age is
increasing in developed countries. Maxillofacial injuries in over-65s
are commonly caused by falls, possibly signifying an increase in
frailty. The comprehensive geriatric assessment (CGA) addresses this
increase, while reducing subsequent frailty-type admissions. No
studies have considered whether to introduce the CGA following
presentation with a facial injury.
Aims:
To investigate whether facial injury in the elderly is a sign of
increased frailty by using secondary healthcare needs as a marker
of need. To establish whether there is a difference in the hospital
admission time pre- and post-facial injury. To investigate the number
of frailty-type admissions post-injury. To look at patients
’
co-
morbidities in order to further target the CGA.
Methods:
Patient records were searched in the Emergency
Department to identify elderly patients who presented with a facial
injury. Records were analysed between October 2008 and October
2013. Standard statistical tests were used to look for differences in
admissions pre and post injury.
Results:
107 patients were identified. There was a statistically
significant difference between the number of days spent in hospital
pre-versus post-injury; 3.34 days:6.33 days (P = 0.031). 39% of patients
re-admitted following facial injury with a frailty-type admission.
There was a significant relationship between haematological co-
morbidities and frailty admissions post-injury (P = 0.019).
Conclusion:
Facial injury may be a suitable proxy marker for frailty.
Our findings suggest that implementing the CGA would be worth-
while, as presentation with a facial injury is a marker for increased
future healthcare needs.
P-265
Personal preferences and motivations of a person and two
relatives before total hip arthroplasty: a case report with a
narrative analysis
E. Oosting
1,2
, J. Dronkers
1
, T. Hoogeboom
2
, N. van Meeteren
2,4
,
W. Speelman
5
.
1
Hospital Gelderse Vallei, Ede,
2
Maastricht University,
Maastricht,
3
Radboud University Medical Center, Nijmegen,
4
Top sector
Life Sciences & Health, The Hague,
5
Tilburg School of Theology,
the Netherlands
Introduction:
Besides medical or physical functioning [1] related
information, health providers should have insight into the personal
impact of a disease in a person
’
s life. The purpose of this study is to get
insight into personal preferences and motivations of a patient involved
in a physical therapy intervention.
Methods:
Mrs A, a 76-year-old woman with severe comorbidity is
preoperatively referred to a physical therapist (PT) for functional
assessment and training before total hip arthroplasty (THA). The
patient, her daughter and her PT were asked to write a story about
their daily life. All stories were analyzed according to the narrative
scheme [2], which consists of four phases: 1. Motivation; 2. compe-
tences; 3. Performance; and 4. Evaluation.
Results:
Mrs A was mainly motivated by her will to do enjoyable
social activities and stay independent. Although she has the
competence to try her best to undertake those activities (a perfor-
mance) that make her proud (evaluation), her pain and physical
limitations were anti-competences that motivate her to attend
health care. Although the PT seemed to be aware of these personal
participation goals, her main focus was on improving and evaluating
functions and activities [1]. The daughter alsowanted her mother to be
able to do enjoyable activities and did not see herself as an informal
caregiver.
Key conclusion:
The narrative method was a valuable tool to clarify
personal preferences and motivations of this person within her
context before THA. This knowledge could help caregivers in applying
shared decision-making and patient centered treatment and goal
setting.
References
[1] WHO.
ICF. international classification of functioning, disability and
health
. Geneva: World Health Organization; 2001.
[2] Speelman WM. A spiritual method for daily life practices. In:
Hense E, Maas F, editors.
Towards a Theory of Spirituality
. Leuven:
Peeters; 2011. p. 55
–
71.
P-266
Comparison of geriatric syndromes according to gender over
seventy-five years old in the elderly
C. Kilic
1
, A. Baskent
2
, G.B. Bahat
1
, F. Tufan
1
, M.A. Karan
1
.
1
Department
of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul
Faculty of Medicine,
2
Department of Physical Medicine and
Rehabilitation, Istanbul University, Istanbul Faculty of Medicine, Istanbul,
Turkey
Objectives:
In this study, individuals over seventy-five years old living
in the communitywas undertaken to examine the situation of geriatric
syndromes according to gender.
Methods:
In the study; 203 patients, 67(33%) were male and 136(67%)
were female. The mean age 80,92 ± 4,3(76
–
99); of group total; in
men 80,75 ± 4.5(76
–
92) years, and women women 81,01 ± 4,2(76
–
99)
years. Patients with urinary incontinence, fecal incontinence, sleep
disorders, falls, chronic pain, malnutrition and the effects, visual
impairment, hearing impairment, immobility, cognitive impairment,
balance and gait disturbances, depression and constipation, geriatric
syndromes were questionned. General total, average, and percentage
comparisons between gender groups were evaluated using appropri-
ate statistical methods.
Results:
The mean number of geriatric syndromes in cases were
4,0 ± 2,5(0
–
11). The mean number of geriatric syndromes in men by
gender was 3,0 ± 2,2(0
–
10), while in women was 4,5 ± 2,5(0
–
11),
respectively. Women
’
s average number of geriatric syndromes, were
statistically higher than men to be highly significant (t =
−
3.98,
p = 0.000). When the groups by gender in the prevalence of geriatric
syndromes examined, about urinary incontinence, sleep disorders,
chronic pain, malnutrition and the effects, immobility, balance and
gait disorders there was statistically significant difference (p < 0.05).
Other; there wasn
’
t any statistically significant difference in fecal
incontinence, falls, visual impairment, hearing impairment, cognitive
impairment, depression and constipation (p > 0.05).
Conclusion:
Old age is a period of life that is accompanied by a lot of
health problems. This study shows that the number of geriatric
syndromes in the female gender are higher than in men of the
elderly. It will be considered that, the programs for the elderly, would
be useful for the necessary evaluation regarding common geriatric
syndromes.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29
–
S259
S99