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Malnutrition is a frequent condition in the elderly that

can result in poor health outcomes. Our aim was to analyze outcomes

at 6 and 12 months (6M and 12M) of a cohort of patients

75 years

admitted in an Internal Medicine Ward according baseline nutritional



Prospective longitudinal cohort study of 100 patients.

Comprehensive geriatric assessment at baseline, including nutritional

assessment (Mini Nutritional Assessment (MNA), bioimpedance,

anthropometry, serum total protein (TP) and albumin). Barthel score

at 12M, survival and hospital readmission at 6 and 12M assessed by

phone contact and hospital record analysis.


One patient lost during follow-up. Average age 83.7 years, 63%

males, average Cumulative Illness Rating Scale Geriatrics 11.2, average

baseline Barthel score 63.6, 32% cognitively impaired. 70% malnour-

ished according MNA. Cumulative mortality: 6M 48.4%, 12M 53.5%.

Therewas statistically significant association between: mortality at 6M

and MNA categories (p 0.015), albumin (p 0.032) and TP (p 0.007);

mortality at 12M and MNA categories (p 0.026), body mass index

(BMI) (p 0.026), albumin (p 0.041) and TP (p 0.003). Kaplan-Meier

survival curves supported these results. Predictors of rehospitalisation

were not identified. Higher TP was associated with emergency

department admission (p 0.017). Higher BMI was associated with

maintenance of functional status at 12M. Bioimpedance parameters

were not predictors of outcome.


Malnutrition according MNA, lower BMI, lower albumin

and TP are predictors of poor outcome of hospitalized older patients.

Higher BMI is a protective factor as it is associated withmaintenance of

functional independence.


Hyperthyroidism in elderly hospitalized patients: what can we

do better?

I. Ferrando Lacarte, B. Gamboa Huarte, C. Deza Perez, M. González

Eizaguirre, E. García-Arilla Calvo.

Geriatrics Service, Hospital Nuestra

Señora de Gracia, Zaragoza, Spain


In August 2015, The European Thyroid Association

Guidelines on Diagnosis and Treatment of Endogenous Subclinical

Hyperthyroidism were published, collecting current evidence, trying

to resolve discrepancies identified in the management of this

condition. We set at objectives to know clinical practice performed

in patients with hyperthyroidism and subclinical hyperthyroidism

(type 1 and type 2) in a geriatric service.


Descriptive analysis, reviewing patients admitted from June

to December 2014 (318 patients). Collected sociodemographic para-

meters, personal history, functional status (Barthel index), forecast

mortality (Charlson index), biochemical parameters, and one-year

mortality. SPSS v19.


Thyroid background 10.7%, 4 (1.3%) hyperthyroidism.

Admission: 12 (3.8%) TSH below the normal range: 4 hyperthyroidism

(36.4%), 2 subclinical hyperthyroidism type 2 (18.2%) and 5 subclinical

hyperthyroidism type 1 (45.5%), one unclassifiable (not FT4 available).

Subclinical hyperthyroidism prevalence: 2.2%. Any patient received

treatment at discharge and only three follow-up recommendationwas

made. Postdischarge 4 (40%) patients are monitored (3 primary care, 1

endocrine) and require treatment 2 (20%). Hospital mortality: 25%

hyperthyroidism; Subclinical hyperthyroidism type 1 20%; Subclinical

hyperthyroidism type 2 0%. Year mortality: 0% hyperthyroid patients;

Subclinical hyperthyroidism type 2 50%; Subclinical hyperthyroidism

type 1 25%.


The prevalence of subclinical hyperthyroidism in our

sample is in the lower limits of the results of the NHANES III

study. Despite the low prevalence, mortality associated data, 20% and

50% per year, should make us reflect and deepen the knowledge

and approach of subclinical hyperthyroidism in patients older than

75 years.


Nutritional risk in heart failure

a retrospective study

I. Figueiredo, S. Guerreiro Castro, G. Magalhães, M. Antunes,

M. Perestrelo, H. Gruner, A. Panarra.

Serviço de Medicina Interna 7.2,

Hospital Curry Cabral, Centro Hospitalar Lisboa Central

Heart failure (HF) has high morbidity and mortality rates, especially if

associated with comorbidities, aging and poor nutrition. Our aim is

to evaluate the nutritional risk in HF and its impact on length of

hospital admission, infectious complications, readmissions within 1

and 6 months and mortality. We performed a retrospective study

of all patients admitted to the Medical ward in 2015 with HF (ICD-9)

who had a nutritional evaluation, by analyzing the files. Age, sex,

dependency status and comorbidities were characterized through the

Charlson Score (CS) and stratified by the Malnutrition Universal

Screening Tool (MUST) in low (LR), medium (MR) and high risk (HR),

with evaluation of the referred endpoints. Of a total of 3014 patients,

331 were admitted with HF, of which only 119 had nutritional

evaluation. Of these 119, 63.9% were womenwith a median age of 82.9

years and 76.5 years for men. MUST stratified the patients in: 59.7% LR,

7.6% MR and 29.4% HR. CS (4

13) was 7.9 in LR, 7.1 in MR and 8.2 in HR.

Regarding the endpoints, CS was 7.9 when infectious complications

were present, 8.2 in readmissions within 1 month and 8.8 within 6

months and 7.8 in mortality. The incidence of nutritional risk was the

same as other studies, in spite of a different evaluation tool. After

crossing data with CS, it seems to be related with readmissions and

infectious complications. There is a possible bias as a nutritional plan

can be initiated by the nutritional team on patients at risk.


Feeding of dementia inpatients within the Buckinghamshire

Healthcare NHS Trust: a survey exploring the views and experience

of foundation doctors and nurses

M.V. Foy


, B.V. Nagyova


, D. Begent




Buckinghamshire Healthcare NHS

Trust, Buckinghamshire, United Kingdom


The progression of dementia presents the healthcare

teams with complex feeding challenges, especially towards the end

stages of the disease. The Royal College of Physicians developed a

guidance document for the management of patients with swallowing

difficulties [1]. At present, we do not have trust guidelines to assist

with the feeding of dementia inpatients. Within our organization,

foundation doctors and nurses are the first responders when feeding

problems arise. We set out to investigate their views and experience

regarding the feeding of dementia inpatients, with the aim to find out

if they were facing any issues, and what these were.


We undertook two qualitative surveys for foundation

doctors and nurses caring for inpatients with dementia within our


s hospitals. The questions were in multiple choice and

open formats.


33 doctors and 39 nurses answered. 30% of doctors and 79% of

nurses mentioned they had experienced issues regarding the feeding

of dementia inpatients. The main challenges described by both

surveyed cohorts were related to: low oral intake resulting in poor

nutrition; communication issues and discordances with the family;

alternative feeding routes; and poor swallow with potential risk of

aspiration pneumonia.


The issues described by both populations were wide-

ranged, and most of them well understood in relation to dementia.

Both surveyed cohorts wouldwelcome further training on this subject.

Our project supported the development of trust guidelines for the

assessment and management of patients with swallowing difficulties,

which are currently awaiting approval by the trust.


[1] Royal College of Physicians and British Society of Gastroenterology.

Oral Feeding Difficulties and Dilemmas: A Guide to Practical Care,

Particularly Towards the End of Life

. London. Royal College of

Physicians, 2010.

Poster presentations / European Geriatric Medicine 7S1 (2016) S29