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

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Conclusions: Studies don ′t include patients in this group, which
entails complex decisions. We conclude that treatment should focus
on functional status and not in patients age.
P-526
Nutritional assessment of elderly people with pressure ulcer
occurrences
T. Santos, M. Cravo. Serviço de Dietética e Nutrição e Serviço de
Gastroenterologia do Hospital Beatriz Ângelo
The objective of this study was the assessment of the nutritional
situation of a population of elderly individuals and its possible
association with Pressure Ulcer (PU) occurrences. 80 elderly patients
(40 with PUs and 40 without PUs) have been assessed from January to
March 2016 on parameters such as sociodemographic background,
clinical history, anthropometric parameters (Body Mass Index (BMI),
Arm Circumference, Geminal Perimeter (GP), Triceps Skinfold, Sub-
Scapular Skinfold), body composition (Fat Free Mass (FFM), Fat Mass
(FM), Phase Angle), nutritional risk (MUST ®), subjective nutritional
assessment (MNA®) and biochemical parameters (haemoglobin, total
proteins, albumin and total cholesterol). The risk of development of
PUs has been assessed through the Braden Scale. 40 patients from the
Case Group (Case), 72.5% women and 27.5% men, averaging 83.5 ± 6.3
years old and 40 patients from the Control group (Control), 50%
women and 50% men, averaging 81.6 ± 8.4 years old. As per BMI, 45%
of the Case patients showed malnutrition, while in the Control it
was 32.5%. Following MNA ®, 97.5% of patients showed malnutrition
in Case, while only 7.5% in Control. 92.5% of the patients from
Case revealed albumin concentration under 3.5 mg/dL, while in
Control it was only 22.5%. Between both groups, statistical differences
have been seen in GP (Case = 27.7 cm and Control = 30.3 cm; p = 0.008),
FFM (Case = 35.3 cm and Control = 41 cm; p = 0.002), albumin
(Case = 2.7 mg/dL and Control = 3.8 mg/dL; p = 0.000) and total chol-
esterol (Case = 121 mg/dL and Control = 148.9 mg/dL; p = 0.000).
Albumin (OR: 0.99, 95% CI [0,001–0,102], p = 0,000) and total
cholesterol (OR: 0.974, 95% CI [0,948 –1,000], p = 0,000) have been
seen as a protective factor for the occurrence of PUs. An appropriate
nutritional assessment of patients with PUs can reduce further
deterioration of general health condition, reduce hospital stay and
reduce overall care and treatment cost, ultimately contributing
improve patients quality of life.
P-527
Breast cancer incidence and survival in elderly women
during the 1989–2012 period: a population based-study in a
French area
L. Schoutteten1, M. Colonna2, H. Curé1, P. Delafosse 2, N. Mitha3,
N. Zerhouni3, G. Gavazzi3, A. Seigneurin2. 1 Medical Oncology Unit,
Grenoble Alpes Universisty Hospital, 2Cancer Registry of Isère, 3Gériatric
Unit, Grenoble Alpes Universisty Hospital, La Tronche, France
Introduction: The purpose of our study is to analyse incidence
evolution of breast cancer diagnosed from 1989 to 2012 in elderly
women (>75 y), in a French area. We compared it to other age group
(50–74 years) and established overall and relative survivals at 1 year, 5
years, 10 years.
Methods: This cohort study was based on appropriate population-
based cancer registry data. We used the software JoinPoint to identify
trend break and estimate annual incidence change.
Results: 6,172 women aged 50 to 74 years and 1,893 women aged over
75 years were analysed. The incidence increased, per year, by 7.5%
(IC 95%: 4.1–10.9%) and by 1% (IC 95%: 0.4–1.5%) for elderly women
who had in situ and invasive breast cancer respectively. Overall
survival of women aged over 75 years was 87% (IC 86 –89%), 57%
(IC 54 –59%) and 31% (IC 73–76%) at 1 year, 5 years and 10 years
respectively and was 97% (IC 97 –97%), 85% (IC 84–86%) and 74% (IC 73–
76%) in women aged of 50 to 74 years. Relative survival for women
aged over 75 years with invasive breast cancer was 93% (IC 91 –94%),
78% (IC 75–82%) and 67% (IC 61–74%) at 1, 5 and 10 years respectively
and was 98% (IC 97–98%), 89% (IC 88–90%) and 82% (IC 81–83%) for
women aged of 50 to 74 years.
Conclusion: Women aged over 75 years exhibited more stage IV. They
underwent less surgery and lower survival. A greater disease severity
at the time of diagnosis, and less-effective treatments given to elderly
patients are the most plausible explanations for lower survival.
P-528
Gastric antral vascular ectasia – a rare cause of gastrointestinal
bleeding in the elderly
S. Sintra, C. Filipe, A. Simão, A. Carvalho. Centro Hospitalar e
Universitário de Coimbra, Coimbra, Portugal
Introduction: Gastric antral vascular ectasia (GAVE) syndrome,
also known as watermelon stomach, is a rare but significant cause of
acute or chronic gastrointestinal blood loss in the elderly. The
initial presentation may include occult blood loss leading to
transfusion-dependent chronic iron-deficiency anemia, severe acute
upper-gastrointestinal bleeding, nonspecific abdominal pain, or even
gastric outlet obstruction.
Clinical case: A 87-year-old female patient is brought to the
emergency department for blood transfusion due to anemia. Past
medical history included arterial hypertension, hypothyroidism, diet-
controlled diabetes mellitus and chronic kidney disease for which
she was medicated with darbepoetin alfa for 9 months. She presented
with asthenia and denied visible blood loss. At the admission she
was conscious, hemodynamically stable and presented with skin
pallor. There was no acute blood loss. Laboratory findings showed
microcytic hypochromic anemia (hemoglobin 5.8 g/dL, mean corpus-
cular volume 76.5 fL, mean corpuscular hemoglobin 22.4 pg), ferritin
8 ng/mL, creatinine 1.5 mg/dL, normal hepatic function, platelet
count, prothrombin time, and international normalized ratio. Upper
endoscopy revealed extensive friable vascular ectasias. Although the
anemia was consistent with iron deficiency, the hemoglobin level
invariably decreased to pretransfusion levels within two weeks of
blood transfusion (with a minimum of 3.9 g/dL). After 5 treatment
sessions with argon plasma coagulation, she finally reached a stable
hemoglobin value of 14.4 g/dL.
Conclusions: Althoug GAVE syndrome is a rare medical condition and
represents a diagnostic challenge, it is a cause to consider in elderly
patients with severe anemia and occult or profuse gastrointestinal
bleeding.
P-529
Is the risk of malnutrition associated with NTproBNP
concentration in the elderly?
A. Skalska1, A. Pac2, P. Fatyga1, M. Fedyk- Łukasik 1, T. Grodzicki1.
1Department of Internal Medicine and Gerontology, Jagiellonian
University Medical College, 2Chair of Epidemiology and Preventive
Medicine, Jagiellonian University Medical College, Krakow, Poland
Objectives: The aim of the study was to assess relationship between
nutritional status and NTproBNP concentration in older person.
Methods: NTproBNP concentration, medical history and risk of
malnutrition with Mini-Nutritional-Assessment was evaluated in
patients followed in geriatric outpatient clinic. Body composition
was measured with dual energy X-ray absorptiometry. Relationship of
nutritional status with NTproBNP concentration (in quartiles) was
assessed.
Results: Mean age of 106 examined persons (58.5% men) was
73.1 ± 8.99 years. Heart failure was diagnosed in 77 (72.6%) patients,
in 6 (22.3%) in 1st quartile of NTproBNP concentration, in 19 (73.1%) in
2nd quartile, in 26 (96.3%) in 3rd, and in 26 (100%) in 4th quartile. Risk
of malnutrition was recognized in 30 (28.3%) patients, and percentage
of patients at risk increased in subsequent NTproBNP quartiles
from 18.5% in 1st to 46.2% in 4th quartiles (p = 0.019). Also BMI
decreased from 29.4 kg/m2 in 1st to 26.8 kg/m2 in 4th quartile
(p = 0.048), and total body fat decreased from 40.6 ± 6.4 kg in 1st
quartile to 30.3 ± 8.2 kg in 4th quartile of NTproBNP concentration
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S168