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

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outcome (CAAP-100% HAAP-67% NAP-100%). When protocol applied,
10 and 30 day-mortality rate were elevated (CAAP 30% and 40%, HAAP
22% and 28%, NAP 66% and 100%).
Conclusions: AP is relevant problem in geriatric population due to the
high mortality rate. Clinical approach is limited due to absence of
stratification for severity. Further studies need to be performed in this
special population in order to optimize medical intervention.
P-572
Outcome of geriatric patients with Clostridium difficile associated
diarrhea
J.M. Wendel, S. Langenfeld, M. Vehreschild, R.J. Schulz. St. Marien-
Hospital Cologne, University Hospital Cologne Germany, Germany
Background: Risk factors of multimorbid patients has to be taken into
consideration in terms of infection diseases like Clostridium difficile,
which is often triggered by careless antibiotic therapies and further
medication with proton pump inhibitors for example. The geriatric
departments take over patients from other clinic departments to
continue started therapies, often antibiotic regiments with all their
side effects and consequences.
Methods: In a retrospective case control analyses geriatric patients
with Clostridiumdifficile infectionwere evaluated by the trigger of the
infection and its risk factors. Furthermore various outcome parameters
like kidney function, albumin, potassium and recurrences were analy-
zed. The upcomiong next stepwill be the comparison inmatched pairs.
This is and will be performed as a monocentric clinical trial.
Results: 167 patients were identified with Clostridium difficile
infection, 100 evaluated yet. More than 80% were allocated from
other clinical departments. Patients who suffered from Clostridium
difficile associated diarrhea (CDAD) had to stay and to be treated for a
longer period of time. Each individual antibiotic history was
documented and found a high percentage of peniciline, cephalospor-
ine and quinolone therapy as a risk factor for CDAD.
Conclusions: To avoid Clostridiumdifficile associated diarrheawith all
medical, social and economic effects it is most important to rationalize
antibiotic treatment especially by antibiotic stewardship but also to
treat CDAD effectively. Geriatric patients with all their comorbidities
are more vulnerable for CDAD and have a higher mortality. The
amount of recurrences rises.
P-573
Zoster Vaccine Live: review of postmarketing safety by decade of
life
E.D. Willis 1, M. Woodward1, E. Brown1, Z. Popmihajlov 1. 1Merck & Co.,
Inc., Kenilworth, NJ, USA
Introduction: Zoster Vaccine Live (ZVL) was approved in 2006 for the
prevention of herpes zoster (HZ) and post herpetic neuralgia in
individuals ≥ 50 years-of-age. This analysis describes the safety profile
of ZVL by decade of life.
Methods: Spontaneous postmarketing adverse event (AE) reports
received for ZVL from 02-May-2006 to 01-Nov-2015 from healthcare
providers (HCP) worldwide for patients age ≥50 were reviewed.
Results: A total of 11342 reports, containing 28188 AEs, were
identified. The majority of reports were from those 60 –69 years
(48%) followed by 70 –79 (28%), 50–59 (14%); and ≥80 years (10%).
Overall, injection site reaction (ISR) (n = 6788; 24%) and herpes
zoster (HZ) (n = 2577; 9%) were the most frequently reported AEs. ISR
was the leading AE in ages 50–79 and HZ in those ≥80 years. Median
time to onset (TTO) fromvaccination to AE for ISRwas 2 days. In slightly
over half of the reports of HZ, TTO was ≤14 days postvaccination. HZ
was also themost frequently reported serious AE among all age groups.
In the majority (75%), HZ was considered serious because the HCP
reported the event to be either medically significant or disabling.
Sixteen events (<1%) of disseminated HZ (DHZ) in ages 50–59 (n = 1),
60 –69 (n = 5), 70–79 (n = 6) and ≥80 years (n = 4) were reported; 40%
of the patients were reported to be immunosuppressed. The remaining
AEs were reported similarly across the age groups.
Key conclusions: DHZ was reported very rarely. The most frequently
reported AEs for ZVL are similar by decade of life.
P-574
Etiology of the bacterial urinary tract infections (UTIs) in elderly
patients – does gender matter?
Z.B. Wojszel1,2, M. Toczyńska-Silkiewicz3. 1Department of Geriatrics
Medical University of Bialystok, 2Department of Geriatrics, Hospital of the
Ministry of the Interior in Bialystok, 3Germedica, Specialist Medical
Practice, Bialystok, Poland
Introduction: Bacterial urinary tract infections (UTIs) are the most
frequently occurring infection in the geriatric population. Often they
require the use of empiric antibiotic therapy, carrying the risk of
increasing bacterial resistance. The aim of the study was the
assessment of gender differences in etiological factors of UTIs in the
geriatric in-patients.
Methods: Retrospective analysis of bacteriological urine test results
performed in 2365 patients 60-year-old and older, hospitalized on
non- surgical wards of the Hospital of the Ministry of Interior in
Bialystok (years 2006– 2013) was conducted. Patients with bacteriuria
≥CFU and clinically diagnosed UTIs were selected.
Results: The etiologic factors of 958 UTI cases were identified. Gram-
negative bacteria were found in 87,2% cases of women and in 77,1%
of men (p < 0,001). In women, the most frequently isolated pathogen-
found in 72,2% of cases-was Escherichia coli (versus 40,0% in men).
In men Proteus spp (20,6% versus 6,3% in women), “other
Enterobacteriaceae” group (11,8% versus 7,7%), non-fermenting
Gram-negative bacilli (4,7% versus 0,9%), and other Gram-positive
cocci (18,2% versus 9,1%) were more common. Differences in the
frequency of pathogen occurrence between the groups in most cases
were statistically significant.
Key conclusions: There are significant differences in the profile
of etiological factors of UTIs in geriatric in-patients between men and
women. While the pathogen responsible for the majority of UTIs
among older women is Escherichia coli, the greater share of other
Gram-negative and Gram-positive bacteria in men is observed.
Area: Longevity and prevention
P-575
Risk of falls in the elderly: what is our reality?
S. Vieira1, P. Araujo2, S. Amaral3, R. Parreira4, M. Goncalves5,
C. Damasio6. 1USF do Parque, 2USF do Parque, 3USF do Parque, 4USF do
Parque, 5USF do Parque, 6USF do Parque, Lisbon, Portugal
Introduction: The incidence of falls increases with age and frailty, and
it is estimated to occur in 28–35% of the elderly population (≥65 years).
About 10% of falls result in fractures or mortality. In the portuguese
accidents monitoring system, falls in the elderly accounted for 87.1% of
the cases. Our aim is to evaluate the risk of falls in elderly in our
primary care facility.
Methods: Timed Up and Go (TUG) and Falls Efficacy Scale (FES) tests
and questionnaires inquiring risk factors, history and consequences of
falls were applied to users ≥65 years who resorted to consultations at
USF do Parque during a period of thirty days. All data was statistically
processed in Excel.
Results: 64 individuals participated in this study, 41 female, with an
average of 79 years. About 45% reported difficulties inwalking and 27%
had at least one episode of fall, resulting in fractures in 2 cases.
However, only 13% used support during the march. No patients
expressed fear to fall through FES but 63% of subjects showed
increased risk for falling through TUG test. These individuals had
risk factors for falling, namely articular/neurological disorders,
benzodiazepines/alcohol consumption.
Conclusion: The proportion of elderly at high risk of fall was high.
Most of the patients did not admit to have difficulty inwalking, fewuse
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S180