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

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(Partially founded with grants from Abbott Laboratoires S.A. and
Nutricia Advanced Medical Nutrition).
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Geriatric study in municipality of Fatih: sarcopenia and sarcopenic
obesity in elderly patients according to different indexes
C. Kilic1, G. Bahat1, T. Fatih1, S. Avcı 2, T. Akcan3, Y. Medik3, M. Karan 1.
1Division of Geriatric, Department of Internal Medicine, Faculty of
Istanbul Medicine, Istanbul University, 2Division of Geriatric, Department
of Internal Medicine, Faculty of Cerrahpasa Medicine, Istanbul University,
3Faculty of Istanbul Medicine, Istanbul University, Istanbul, Turkey
Introduction: In our study we evaluate patients with different defini-
tions of sarcopenia and sarcopenic obesity and compare prevalence of
cases.
Methods: We enrolled patients ages between 60 and 101. Skeletal
muscle mass were measured with bioimpedance analyse (TANITA-
BC532). Muscle mass assessed with Baumgartner-index. In addition;
muscle mass values calculated according to Janssen, FNIHa and FNIHb
definitions and low muscle mass evaluated according to national data
base. Low body mass was defined as a <9.2 kg/m2 and <7.4 kg/m 2
or <32 kg and <22 kg in male and female patients respectively.
Sarcopenia defined as low-skeletal-muscle-mass-index and decreas-
ing in muscle function according to EWGSOP ’s-sarcopenia definition.
Our population’s data <33 cm accepted as a low-calf circumference.
Together with, obesity assessed with two different definition; a
percentage body fat >=60TH percentile or BMI 30 kg/m 2 suggested in
literature.
Results: This was a study of 204 elderly patients.(mean-age:75,4 ± 7.3).
Sarcopenia and its components’ prevalence are as follows: Sarcopenia
(S) according to Baumgartner index: 5.3%, low muscle mass: %9.8,
dynapenia: %51.5, slower walking tempo: %25.6. On the other hand;
S-prevalence according to Janssen, FNIHa&FNIHb were: 29.3%,37.9%
and 18%, respectively. Lower calf circumference as an indirect indicator
of lower body-mass was %15,8. SO-prevalence measured with
Baumgartner-BMI is 0%, with FNIHa-BMI is 24.9%, with FNIHb-BMI
is 13.2%. Besides; SO-prevalence measured with Baumgartner-Zoico
ile 2.1%, with Janssen-Zoico is 18.2%, with FNIHa-Zoico is %23.4, with
FNIHb-Zoico is 14.7%. S-prevalence is higher among women with
Janssen and FNIHa (p < 0.001). Similarly, SO-prevalence is higher
among women with Janssen-BMI, FNIHa-BMI, FNIHb-BMI, Janssen-
Zoico&FNIHa-Zoico (p < 0.001, p < 0.001, p = 0.02, p < 0.001, p = 0.003).
According to Baumgartner-Zoico definition women don ’t have SO
thereby it is more common in men, meaningfully (p = 0.012).
Key conclusions: SO-prevalence have been the lowest according to
Baumgartner index. The highest S-prevalence has been detected with
FNIHa description and the lowest has been detected with FNIHb. S&SO
correlation with gender vary among different methods. Our results
have shown that S&SO is most likely higher in women.
P-358
Hip fracture mortality and grip strength. Any relationship?
M. Neira Álvarez, E. Arias Muñana, A. Morales Fernandez, R. Bielza
Galindo, J.F. Gómez Cerezo. Hospital Infanta Sofía. Universidad Europea
de Madrid. Madrid. Spain
Objective: To identify variables related to mortality after hip fracture
treatment in elders.
Methods: This prospective observational study included 127 patients
who were admitted to Orthogeriatric Unit of Infanta Sofia ’s Hospital
for hip fracture surgery from April 2013 to April 2014. The main
objective was to evaluate the impact of grip strength as predictor of
functional recovery. This is a mortality sub analysis.
At the time of admission were recorded: age, sex, functional status
(Barthel Index), mental status (Cruz Roja Index) and hand grip
strength. Follow-up was performed 3 months after discharge to assess
functional status and survival.
Results: Out of 127 subjects, 103 were women and 24 were men. Mean
age was 85,1 ± 0,6 years. Hand grip strength was obtained in 85
patients (76.5%), values were between 3,3 and 24,8 Kg and 81 patients
(95,2%) had values below cut‐point for sarcopenia.
19 patients died during the three months follow up (15%). Hand grip
strength was obtained in nine of them; mean value was 10,7 ± 0,5 Kg
and no relation was founded between grip strength and mortality
(p = 0,79).
By simple linear logistic analysis sex (p = 0,03) and Barthel Index
(p = 0,01) at admission shown relation to mortality. In the multiple
linear regression sex was the most strongly associated with mortality
(p = 0,02).
Conclusions: Hip fracture has a significant impact on mortality among
elders.
Hand grip strength had no relationship with mortality in hip fracture
patients.
Factors related to mortality were sex and previous functional status.
The authors have no financial support from commercial parties.
P-359
Comparison of frailty screening instruments in the emergency
department
M. Costello1,2, L. Spooner3, C. Small1, A. Flannery1, L. O’Reilly3,
L. Heffernan3, E. Mannion 4, O. Sheil 4, S. Bruen4, P. Burke4,
M. McMahon4, N. Kyne4, W. Molloy 5, A. Maughan6, A. Joyce6,
H. Hanrahan2, G. Stallard3, J. O ’Donnell3, R. O’ Caoimh1,2. 1Department of
Geriatric Medicine, University Hospital Galway, Newcastle rd, Galway
City, 2Health Research Board Clinical Research Facility Galway, National
University of Ireland, Galway, Geata an Eolais, University Road, Galway,
3Department of Emergency Medicine, University Hospital Galway,
Newcastle road, 4Frail Elderly Assessment Team, University Hospital
Galway, Newcastle road, Galway City, Ireland, 5Centre for Gerontology and
Rehabilitation, University College Cork, St Finbarrs Hospital, Douglas Rd,
Cork City, Ireland, 6PCCC, Shantalla Health Centre, Costello road, Galway
City, Ireland
Introduction: Although several frailty screens may be suitable for use
in the Emergency Department, it is not known which is most accurate
and practical to deploy in clinical practice.
Methods:We compared the accuracy of three validated, short, frailty
and risk-prediction screening instruments to predict frailty at triage in
a university hospital ED. Consecutive older adults aged >70 years self-
administered the PRISMA-7 and the ISAR on arrival to ED triage.
Trained nurses independently scored the Clinical Frailty Scale (CFS)
blind to the diagnosis and the results of the self-administered
screening. A consultant physician using a battery of frailty instruments
including the FRAIL Scale independently determined each patient’ s
frailty status.
Results: In total, 210 patients were screened, median age (interquartile
range +/−) 79 (+/−9) years of which 47% were male. Based upon the
FRAIL scale classification 28% of patients were classified as robust, 40%
pre-frail and 32% as frail. The median ISAR score was 3 (+/−3), CFS 4
(+/−2) and PRISMA-7 3 (+/−2). Inter-rater reliability of the CFS was
strong, r = 0.78. The most accurate instrument for separating frail
from non-frail (including pre-frail) was the PRISMA-7,(AUC 0.88; 95%
CI:0.83–0.93) followed by the CFS (AUC 0.83; 0.77–0.88) and the
ISAR (AUC 0.78; 0.71–0.84). The PRISMA-7 was statistically signifi-
cantly more accurate than the ISAR (p = 0.008), but not the CFS (z = 1.4,
p = 0.15). The PRISMA-7 was also the most accurate at differentiating
pre-frail from frail (AUC of 0.71; 0.62– 0.79).
Conclusion: Screening for frailty in the ED with a selection of short
screening instruments is reliable and accurate The PRISMA-7 was the
most accurate, consistent with findings in primary care.
P-360
Point prevalence of frailty in the emergency department
C. Small1, L. Spooner2, M. Costello3, C. Small 1, A. Flannery1, L. O’ Reilly2,
L. Heffernan2, E. Mannion 4, O. Sheil 4, S. Bruen4, P. Burke4,
M. McMahon4, N. Kyne4, W. Molloy 5, A. Maughan6, A. Joyce6,
H. Hanrahan2, G. Stallard2, J. O ’Donnell2, R. O’ Caoimh1,3. 1Department of
Geriatric Medicine, University Hospital Galway, Newcastle rd,
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S124