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

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care and improved satisfaction among older people towards proactive
primary care, but the GP cannot delegate this role completely.
P-282
Frail older people after hospital discharge: follow-up at three and
six months of patients discharged either to postacute care unit
(PCU) or home
O. Vazquez 1, E. de Jaime1, C. Roqueta1, R. Miralles1, M.J. Robles1,
D. Sanchez 1, P. Garcia1, M. Garreta1, A. Renom1. 1Geriatrics Department,
Centre Forum, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
Introduction: This study aims to compare the results at three and six
months of two cohorts of frail older people who were discharged from
the hospital to either a PCU or home.
Methods: Prospective observational study of 75 patients hospitalised
in an acute hospital ward, aged ≥65, who fulfilled the admission
criteria for PCU: inability to transfer from the chair/bed, inability to
walk alone, altered mental status and absence of severe dementia/
terminal disease. The availabilityof an informal caregiver was required.
Patients could choose between admission to PCU or discharge home.
At discharge, 3 and 6 months we gathered information on: age, sex,
functional status (Barthel and Lawton Index), cognitive status (MMSE),
main disease, Charlson, number of drugs, readmissions, falls and
adverse events (defined as readmission episode and/or ≥2 falls).
Results: 42 patients were admitted to PCU while 35 were discharged
home. No significant differences in the variables studied were found at
discharge. At three months,15 had died and 8 were lost, distributed
equally in both groups (p = 0.785 and p = 0.664, respectively). Patients
admitted to PCU suffered less readmissions (26.3 vs 73.7%, p = 0.005),
were prescribed more drugs (3.8 ± 2.4 vs 5.4 ± 2.4, p = 0.028) and
suffered more often from adverse events (30.4 vs 69.6%, p = 0.004).
At six months, no significant differences were found in mortality,
readmissions and drugs prescribed.
Key conclusions: In frail older people, admission to PCU after hospital
discharge might have positive effects on polypharmacy, risk of
readmission and falls at three months with respect to discharge home
P-283
Screening for frailty in older hospitalized patients: reliability and
feasibility of the Maastricht Frailty Screening Tool for Hospitalized
Patients (MFST-HP)
R.M.J. Warnier, E. van Rossum, W.J. Mulder, J.M.G.A. Schols,
G.I.J.M. Kempen. Maastrcht University Medical Center, Maastricht
University
As nurses in hospitals are confronted with increasing numbers of
older patients, their geriatric nursing skills and knowledge must be
integrated into daily clinical practice. Early risk identification via
screening tools may help to improve geriatric care. To reduce the
assessment burden of nurses, the Maastricht Frailty Screening Tool for
Hospitalized Patients (MFST-HP) was developed, a tool that is fully
integrated in the initial nursing assessment. The aim of this study was
to explore aspects of reliability, validity and feasibility of the MFST-HP.
The Intraclass Correlation Coefficients for both intra- and inter-rater
reliability were good (ICC above .93). Older patients and those with
more comorbidity showed higher scores on the MFST-HP compared to
younger patients and those with less comorbidity. Administration
time averaged 2.6 minutes (SD = 0.9) and the response burden among
patients was acceptable. The MFST-HP shows promise as a reliable,
valid and feasible screening tool for frailty among hospitalized older
patients.
P-284
Usefulness of the revised simplified Short-TermMemory Recall Test
(STMT-R) in acutely ill geriatric patients; Approach to a new short
cognitive screening test
K. Ogawa1, K. Yamamuro1, T. Ishitake1, N. Kobayashi2. 1Yamamoto
Memorial Hosp., Kurume Univ., 2Kozansou Azuma St. Clinic
Introduction: Cognitive dysfunction is a prevalent condition in
acutely ill geriatric patients, but often remains undetected. The
MMSE (Mini-Mental State Examination) is broadly used, however
a quicker clinical identification in acutely ill geriatric patients would
be useful. We herein use a revised version of STMT [1] (a maximum
score 8; cutoff point 4) (STMT-R) to evaluate its usefulness and
compared with ages, gender, underlying diseases and clinical outcome
as comparative factors.
Method: Previously, MMSE and STMT-R scores were compared in 32
outpatients and we found a positive correlation (r = 0.625 p < 0.001).
The inclusion criteria were to measure in STMT-R within one
week after admission, age ≧50 yo and being non-critical ill. Among
1,190 patients (between October 2014 and September 2015), 885
consented and were enrolled. STMT-R ≦ 4 was considered as cognitive
dysfunction.
Result: Enrolled subjects had a mean age of 78.9, 52.2% were female
and 10% were with history of dementia. They had uncompleted
cognitive testing with delirium and poor hearing (n = 159), cognitive
dysfunction(STMT-R ≦ 4; n = 460) and non-cognitive dysfunction
person (STMT-R > 4; n = 266). Statistically, the significant differences
were recognized to the age, history of dementia, internal medicine
diseases, respiratory illness and hospital death rate by cognitive
dysfunction (p < 0.01).
Conclusion: (1) STMT-R is expected to be a standard cognitive test in
acute ill geriatric patients. (2) It was suggested that the age, history
of dementia , internal medicine diseases and respiratory illness had
an influence on the cognitive functional decline, and the cognitive
dysfunction could affect the clinical outcome.
Reference
[1] Kobayashi N et al. Development of a simplified Short-Term
Memory recall Test (STMT) and its clinical evaluation. Aging Clin
Exp Res 2010, 22(2) 157.
P-285
Comprehensive geriatric care in elderly referred to a rehabilitation
unit – a randomized trial
D. Zintchouk1, T. Lauritzen2, E.M. Damsgaard1. 1Department of
Geriatrics, Aarhus University Hospital, 2Department of Public Health,
Section of General Medical Practice, Aarhus University
Introduction: Elderly with multiple illnesses represent the fastest
growing sector of society and make increasing demands on all
sectors of the health care system, particularly in community
rehabilitation units due to shorter time of stay in acute care units
and hospitals. The aim of this study was to investigate the effect
of geriatrician-performed comprehensive geriatric assessments
and intervention with follow up (CGC) in elderly referred to a
rehabilitation unit.
Methods: The study was a prospective randomized controlled trial.
Settings: two community care rehabilitation units in Aarhus
Municipality, Denmark. Inclusion: elderly aged 65 and older from
home or hospital. Exclusion: elderly who received palliative care
or had been assessed by a geriatrician during the past month.
Intervention: medical history, physical examination, blood tests,
medication adjustment and follow up by a geriatrician. Control:
standard care with the general practitioners (GPs) as back-up. Hospital
contacts (primary outcome), GP contacts, activities of daily living
(ADL), physical and cognitive functions, quality of life, institutional-
ization, medication status, and mortality were assessed at day 30 and
90 after arrival at the rehabilitation unit.
Results: In total, 370 persons were randomized (184 control/186
intervention group). The mean age was 77.9 ± 7.9/78.3 ± 8.3 years.
ADL was improved or maintained in 113 (63%)/128(70%), OR = 1.36,
CI = 0.9–2.1 within 90 days. No difference in mortality was demon-
strated. Analyses on hospital contacts are ongoing.
Key conclusions: Geriatrician-performed CGC does not seem to affect
the ADL and mortality compared to standard care.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S104