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

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Conclusion: This prospective study confirms the burden of HZ and the
increasing risk for developing PHN with age in German individuals
aged ≥50 years.
P-568
Clinical and economic burden of pneumococcal disease in older
adults with immunocompromising conditions in the United States
H.K. Yang, D. Zhang, P. Mavros, T. Petigara. Merck & Co., Inc., Kenilworth,
New Jersey, USA
Background and aims: Older adults with immunocompromising
conditions are at high risk for pneumococcal infection. Limited studies
have examined both the clinical and economic burden of pneumo-
coccal disease in this population. We assessed pneumococcal disease
rates, resource utilization and costs in US adults 65+ years with
immunocompromising conditions indicated for pneumococcal vac-
cination by ACIP.
Methods: A retrospective cohort study using medical and
pharmacy claims from Humana health plans was conducted to
compare rates and cost of all-cause pneumonia, pneumococcal
pneumonia and invasive pneumococcal disease (IPD) in older
adults 65 + y with and without immunocompromising conditions.
Conditions of interest included chronic renal disease, cancer, asplenia,
transplant and HIV.
Results: Among 4.3 million older adults included in the analysis, 34%
had no immunocompromising condition; 16.1% had chronic renal
disease, 15.5% cancer, 0.2% asplenia, 0.1% transplant and 0.06% HIV.
Older adults with immunocompromising conditions had 3 times the
rate of all-cause and pneumococcal pneumonia, and 5 times the rate of
IPD compared to healthy older adults respectively. All-cause and
pneumococcal pneumonia rates were highest in transplant and
asplenia patients. IPD rates were highest in transplant and HIV
patients. Per IPD episode, adults with immunocompromising condi-
tions had more hospital visits and longer length of stay compared to
healthy adults – 1.0 vs. 0.8 visits and 8.3 vs 6.6 days respectively, but
substantially higher costs ($13,694 vs. $10,510). IPD costs were highest
in transplant ($18,442) and HIV patients ($15,715).
Conclusion: Older adults with immunosuppressive conditions are at
high risk of pneumococcal disease, consume more healthcare
resources and incur greater costs.
P-569
Anti-pneumococcal vaccination in the elderly of Autonomous
Region of Madeira
C. Teixeira, D. Romeira, L. Maia. SESARAM, EPE
Introduction: invasive pneumococcal infections are an important
cause of morbimortality in high-risk groups, especially those over
65 years. Of the latter, the ones with comorbidities exhibit the highest
mortality rate. According to the latest American and Portuguese
standards, vaccination is recommended with Polysaccharide
Conjugate Vaccine 13-valent (PCV13) and Polysaccharide Vaccine 23-
valent (PV23) against infections by Streptococcus pneumoniae in all
immunocompetent elderly. Goal: analysis of antipneumococcal
vaccination status of the elderly population enrolled in the Health
Centres of the Autonomous Region of Madeira (ARM) and relation to
having or not a Family Doctor (FD).
Methods: Observational, transversal and analytical data collection on
vaccination with PCV13 and PV23 against Streptococcus pneumoniae
infections in the elderly enrolled in the Health Centre of ARMwith and
without FD. Data was processed with Microsoft Excel and SPSS. It was
recognized a statistical significance at p < 0.05.
Results: Data analysis revealed a pneumococcal vaccination coverage
rate amongst the elderly of ARM of 4.6%, with a statistically significant
difference between those with and without FD. It was also observed a
difference in coverage rates among health centers, being the largest
coverage 13.7% and the lowest 1.7%.
Key conclusions: Regarding that the pneumococcal vaccine is the
most effective way to prevent invasive pneumococcal disease and due
to low regional coverage rate, it is imperative to encourage its’
implementation. Thus we intend to carry out sensitization activities to
the medical community and re-evaluate the vaccination status of this
population after 6 months.
P-570
The effect of age on seasonal influenza A prognosis
Ö. Karasahin1, P. Tosun Tasar2, O. Timur 3, S. Sahin 4. 1Department of
Infectious Diseases and Clinical Microbiology, Region Training and
Research Hospital, 2Department of Geriatrics, Region Training and
Research Hospital, 3Department of Internal Medicine, Region Training and
Research Hospital, Erzurum, 4Department of Internal Medicine, Division
of Geriatrics, Ege University Hospital, Izmir, Turkey
Introduction: Seasonal flu is an acute viral infection caused by the
influenza virus. There are currently two subtypes of seasonal influenza
A circulating in humans: influenza A (H1N1) and influenza A (H3N2).
In this study we aimed to determine the mortality rate in patients
diagnosed with influenza A.
Materials and methods: This prospective study was conducted
among patients presenting to our hospital with influenza-like illness
(ILI) between December 1 andMarch 31, 2016. According to the clinical
diagnostic criteria established by the Centers for Disease Control and
Prevention coughing, sore throat and fever were considered ILI.
Nasopharyngeal swab samples were obtained from 239 patients with
ILI symptoms.
Results: A total of 239 patients were enrolled during the study period.
H1N1 was detected in 67 patients and H3N2 was detected in 62
patients. The age distribution of the patients was 14.0% in the 0–4
years group, 63.6% in the 5– 64 years group and 22.5% in the ≥65 group.
Eleven of the patients with influenza A required treatment in the
intensive care unit. There was a significant difference between age
groups in the need for intensive care (p < 0.05), with the 5–64 age
group requiring less intensive care compared to the 0–4 and ≥65
groups. Thirteen patients died; influenza A infection was detected in 4
of the deceased patients, all of whom were in the ≥65 age group.
Conclusion: Patients over 65 years of age should be vaccinated before
contracting seasonal influenza and must be closely followed if they
become infected with influenza.
P-571
Aspiration pneumonia: a 3 year-retrospective of an inward elderly
population
M. Vasques1, A. Taulaigo1, M. Popovici1, J. Soares1, A. Gonçalves1,
E. Patarata1, T. Bernardo1, H. Gruner1, A. Panarra1. 1Medicina 7.2 –
Hospital Curry Cabral -CHLC, Portugal
Introduction: Aspiration pneumonia (AP) is an important cause of
mortality among the elderly. Although common, its definition is still
unclear, which has major therapeutical implications. In our hospital,
first-line therapeutic protocol consists in amoxicillin-clavulanate for
community acquired AP (CAAP) and healthcare associated AP (HAAP);
piperacillin-tazobactam for nosocomial AP (NAP), or previous recent
(<15 days) antibiotic therapy.
Objectives: Clinical characterization, diagnostic and therapeutic
approach in elderly patients with AP; protocol application rate and
its impact on clinical outcome.
Methods: Retrospective study of patients with AP discharged between
2013 and 2015. Inclusion criteria: (1) age ≥65 years (2) clinical
evidence of pneumonia (3) risk factors for AP or presented aspiration
(4) chest x-ray.
Results: 65 patients with AP, 11 excluded[AVT1]. Mean age: 82.6 years;
98% had comorbidities. Main risk factor was previous stroke (53%).
Cultures were obtained in 44% of patients, 98% without agent isolation.
15% of patients had normal chest x-ray. Adherence to protocol was
significant (CAAP-83% HAAP-78% NAP-94%), with important clinical
improvement (CAAP-40% HAAP-44% NAP-66%). Therapeutic switch
was considerable (CA-AP 10% HA-AP 16% N-AP 8%) with favorable
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S179