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

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points of provided care. The aim of the “Slovak Atrial FIbrillation audit
in Seniors ” (SAFIS) study was to collect national data characterising AF
and its management in seniors.
Methods: 4,252 patients (mean age 80.9 years) aged≥65 years with AF
hospitalised in acute geriatric departments during 2.5 years were
included. In each patient 122 basic parameters were obtained.
Results: AF occurrence was 28.4%. The most common type of AF was
permanent (39.1%). AF was the primary reason for hospital admission
in 5.3% of all hospitalised patients. Out of patients with first diagnosed
AF episode 40% were admitted primarily not for AF. Antiplatelet
therapy was suggested for 36.7% of discharged patients (increasing
from 29.9% in youngest up to 51.2% in patients ≥90 years) and with
decrease during study years. Low molecular weight heparins were
used in 21.4% of patients. Anticoagulation therapy was given in 36.8%
of patients (decreasing from 44.5% in youngest to 17.5% in patients ≥90
years) and with an important increase of novel oral anticoagulants
usage during the study. Some form of pharmacologic thromboembolic
prevention was prescribed in 91.5% of patients.
Conclusions: SAFIS data were also used when developing “Guidelines
of Slovak Society of Gerontology and Geriatrics on the management of
AF in elderly people”.
P-495
Prevalence of orthostatic hypotension
I.B. de Carvalho1, D.M. Ferreira1,2, H. Esperto1,2, M.T. Veríssimo 1,2.
1Faculty of Medicine of the University of Coimbra, 2Coimbra Hospital and
Universitary Center, Coimbra, Portugal
Background: Orthostatic Hypotension is defined as a reduction of at
least 20 mmHg in systolic blood pressure or a reduction at least
10 mmHg in diastolic blood pressure within 3 minutes of orthostatic
position or head-up tilt to at least 60° on a tilt table.
Objectives: determine the prevalence of orthostatic hypotension in
a sample of older adults and evaluate the association between
orthostatic hypotension, comorbidities and drugs.
Methods: A cross sectional study was made in a department of
Internal Medicine of a tertiary hospital, from July to September 2015.
Sixty five elders were included. After giving their informed consent,
the patients answered questions about their clinical background.
Blood pressure was evaluated in the supine position and after 3
minutes of standing.
Results: Prevalence of orthostatic hypotension was 12.3%. In the
outpatients clinic the prevalence of orthostatic hypotension was
14.0% and in medical ward it was 6.7% (p = 0.669). There was not
statistic difference between genders (14.3% women versus 10.0% men;
p = 0.716). Institutionalized patients presented a higher risk to develop
orthostatic hypotension (OR: 18.67; IC95%: [1.47 –237.59]). In this
study, no important associations were found with heart disease,
hypertension, drugs or falls.
Conclusion: Orthostatic hypotension is common in the elderly and
often affects institutionalized patients. It is an important predictor of
morbidity and mortality.
P-496
Is there a proper management of the elderly diabetic patient?
N. Fernandez1, M. Mendieta1, R. Valera1, M. Niño1, V. Malafarina2,
I. Artaza1. 1Igurco Servicios Sociosanitarios, Bilbao, 2Área de Geriatría,
Clínica Los Manzanos, Grupo Viamed, Logroño, Spain
Objective: to evaluate the A1C goals, and the adequacy of the prescrip-
tion of the diabetic patients who entered in our nursing homes in the
past two years.
Material and methods: descriptive study of the socio-demographic,
clinical, cognitive, and functional variables of all diabetic patients.
They were considered A1C goals according to the ADA depending
on macro and microvascular complications, functional status (MBI)
and cognitive impairment (MMSE). The inappropriate prescribing is
definied in relation to drugs with high potential for development of
hypoglycemia.
Results: we studied a population of 88 people, corresponding with a
19.81% of the income patients. They presented a median age of 86.01
years (75–99), 64% women, and a moderate dependency for ADL
[MBI Me 37 (0–100)]. 66% presented target organ injury, there were
diagnosis of dementia in the 75.86% of diabetics, with a median MMSE
of 12 points (2–22). We differentiate the show into three categories,
depending on target organ injury (A1C goal 6,66 ± 1,07, inappropiate
prescribing 11,76%), evidence of cognitive impairment (A1C goal
6,26 ± 1,18, inappropiate prescribing 12,28%) and functional depend-
ency (A1C goal 6,30 ± 1,12, inappropiate prescribing 10,77%).
Conclusions: Diabetes is a prevalent chronic disease, in most cases
with evidence of vascular complications. Furthermore, the coexistence
of dementia and above all, functional impairment is common. In this
sense, we showed that the values of glycosylated hemoglobin of the
diabetic patients to their entry into residence, are far from recom-
mended in clinical guidelines, and drugs contraindicated in elderly,
due to high risk of hypoglycemia, are used in the therapeutic approach.
P-497
Aortic stenosis in the elderly patients aged 80 and over: risk
assessment and predicting outcomes
G. Fuertes-Ferre1, E. Rivero1, A. Pérez1, P. Auquilla1, I. Caballero1,
E. Sánchez1, C. Sanz1, T. Olóriz1, G. Galache1. 1Miguel Servet University
Hospital, Zaragoza, Spain
Objectives: Technical and procedural advances have led to an increase
in older patients with severe aortic stenosis (AS) who can undergo
an invasive treatment strategy (ITS). The purpose of this study was
to identify the prognostic factors for mortality among these older
patients.
Methods: We recruited 151 consecutive hospitalized patients ≥80
years old with severe AS treatedwith surgical (SAVR) and transcatheter
aortic valve replacement (TAVR) or medical therapy (MT). We analyzed
the predictors of mortality after 449 days.
Results: 64 men and 87 women, mean age of 84 years (80–96). SAVR
was performed in 46 patients (30,5%), TAVR in 16 (10,6%). The 62
patients on ITS were younger than those on MT (82 vs 85, p < 0.001)
and had lower dependence in routine activities (1% vs 30%, p < 0.001).
TAVR patients had the highest Euroscore II : 6.93 vs 2.48 SAVR and 5.20
MT. Mortality was increased in patients on MT: 49% vs 22% SAVR vs 12%
TAVR, p < 0,001. Charlson Comorbidity index (CCI) >6 was associated
with higher cardiac death in ITS patients: 22.6% vs 5.4% ICC < 6,
p < 0.034. Cerebrovascular disease (HR 3.871, CI 1.74 to 8.62), cardiac
failure (HR 2.053, CI 1.06 to 3.97), aortic regurgitation (HR 1.58, CI 1.09
to 2.30) and MT (HR 3.49, CI 1.64 to 7.45) were found independent
predictors of mortality.
Conclusions: In this cohort of elderly patients with severe AS, the
interventional approach improved survival rate, resulting TAVR in the
best outcomes. CCI helps predict cardiac death in patients undergoing
SAVR and TAVR.
P-498
Melatonin – does it play a role in the elderly hypertension?
G. Popescu1, S. Dontu2, C. Carjan1, S. Burtica3. 1INGG Ana Aslan, Bucarest,
2Arceda Clinic, Ploiesti, 3Dr. Ion Cantacuzino Hospital, Bucarest, Romania
Introduction: The blood pressure (B.P) has a circadian variation with
diurnal rising and nocturnal fall which define the dipping status. The
old hypertensive patients are generally non-dippers and are more
exposed to complications in cardiovascular area. On the other hand,
the melatonin secretion during the night decrease the B.P values. But
in the old age the melatonin secretion is low, going on to insomnia and
agitation, and so, its role to fall down B.P disappear.
Goal: The present paper reveals the relationship between nocturnal B.
P and melatonin levels in the elderly hypertensive patients, and how
Melatonin drug could play a role in current therapy of them.
Method and results: We studied 10 old patients, 6 males and 4
females aged between 76 and 79 years old, 5 dippers and 5 non
dippers. We determined the urinary excretion of 6 sulfatoxymelatonin
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S160