22 / 290
Methods:
Multicentre, multinational registry in patients undergoing
TAVI. Co-primary objectives are to establish predictive value of CGA
(Multidimensional-Prognostic-Index [MPI], short-physical-perform-
ance-battery [SPPB], SilverCode) for mortality and/or hospitalization
and to demonstrate changes in the CGA after TAVI.
Results:
A total of 72 patients with a mean age of 85.4 ± 2.9 years and a
EuroScore II of 9.7 ± 8.3% were enrolled. Three months after TAVI 94.8%
were classed NYHA I/II (18.8% at baseline; p < 0.001), the MPI was
0.29 ± 0.12, SPPB 7.6 ± 2.9 (p < 0.001), and SilverCode 21.1 ± 7.9 (vs.
0.32 ± 0.10, 5.6 ± 3.3 and 22.0 ± 7.3 at baseline). Eight patients reached
the combined endpoint of death/stroke within 3 months. These
patients had a higher MPI and a lower SPPB at baseline, compared to
those without (MPI: 0.103 [95%CI, 0.031 to 0.176; p=0.006]; SPPB:
−
3.962 [95%CI,
−
6.228 to
−
1.696%; p = 0.001]). In the multivariate
analysis, a high SPPB at baseline was associated with a reduced risk for
stroke and/or death within 3 months after TAVI.
Conclusion:
The results suggest that it might by beneficial to include
CGA into the pre-TAVI assessment to improve outcomes. Lower SPPB
performance appears to best predict poor outcomes within 3 months
after TAVI.
O-054
Outpatient comprehensive geriatric assessment: effects on frailty
A.L. Mazya
1,2
, P. Garvin
3
, M. Unosson
4
, A.W. Ekdahl
1,5
.
1
Department of
Neurobiology, Care sciences and Society, Karolinska Institutet,
2
Geriatric
Department of Danderyd Hospital, Stockholm,
3
Unit of Research and
Development in Local Health Care, Region of Östergötland, Linköping,
4
Department of Social and Welfare Studies, Linköping University,
5
Department of research and education, Helsingborg hospital, Region
Skåne, Sweden
Objectives:
The prevention and treatment of frailty is a great challenge
to health care in the future. Elderly receiving Comprehensive Geriatric
Assessment (CGA) as hospital inpatients have decreased institution-
alization and mortality. This study aimed to analyze the effects of
outpatient CGA on frailty in community dwelling elderly people with
multimorbidity.
Methods:
The Ambulatory Geriatric Assessment
–
Frailty Intervention
Trial (AGe-FIT) was a randomized controlled trial with an intervention
group (n = 208) and a control group (n = 174). Frailty was one of the
secondary outcomes. Participants were community dwelling elderly
peoplewith multimorbidity (N = 382). Inclusion criteriawere: age
≥
75
years,
≥
3 diagnoses per ICD-10, and
≥
3 inpatient admissions during 12
months prior to study inclusion. The intervention group received CGA-
based care in an Ambulatory Geriatric Unit by a multidisciplinary
team. The control group received usual care. Frailty was classified with
the criteria from the Cardiovascular Health Study (CHS) at baseline and
at 24 months.
Results:
After 24 months, there was a significant difference in
proportion of patients classified as pre-frail between the intervention
group and control group, p = 0.029. The mortality was high, 18.8%
(n = 39) in the intervention group and 27% (n = 47) in the control group.
This was expected considering the high risk of mortality related to old
age, multimorbidity and frailty.
Conclusion:
These results suggest that outpatient CGA and subse-
quent interventions could have an important role in delaying
development of frailty.
O-055
Multidimensional prognostic index in hospitalized elderly patients
across Europe and Australia: a prospective multicenter study of the
European MPI_AGE project
J. Daragjati
1
, C. Musacchio
2
, M.C. Polidori
3
, M. Paccalin
4
, C. Miret
5
,
A. Cruz-Jentoft
5
, E. Topinkova
6
, D. Sancarlo
7
, F. Mattace-Raso
8
,
K. Ruxton
9
, A.A. Mangoni
9
, M. Puntoni
2
, A. Pilotto
1,2
, on behalf of the
MPI_AGE.
1
Geriatrics Unit, ULSS 16 Padova, S Antonio Hospital, Padova,
2
Department of Geriatric Care, OrthoGeriatrics & Rehabilitation, Frailty
Area, E.O. Galliera Hospital, Genova, Italy;
3
Ageing Clinical Research, Dpt.
Medicine II, University Hospital of Cologne, Germany;
4
Geriatrics
Department University Hospital La Milétrie, Poitiers, France;
5
Hospital
Universitario Ramón y Cajal, Madrid, Spain;
6
Department of Geriatrics,
First Faculty of Medicine, Charles University, Prague, Czech Republic;
7
IRCCS CSS, San Giovanni Rotondo,
8
Erasmus Universitair Medisch
Centrum, Rotterdam, The Netherlands;
9
Department of Clinical
Pharmacology, Flinders University, Adelaide, Australia
Background:
The Mutidimensional Prognostic Index_Age (MPI_AGE)
is a multicenter project funded by the EU in the frame of the European
Innovation Partnership on Active and Healthy Ageing, Second Health
Programme (2008
–
2013) with the aim to implement the use of MPIs to
improve cost-effectiveness of interventions in multimorbid frail older
persons.
Objective:
The objective of this study (Work Package 6) was to improve
resource allocation in hospitalized older patients by using the MPI, a
validated predictive tool for mortality based on the Comprehensive
Geriatric Assessment (CGA).
Methods:
1,017 individuals aged 65 years and over admitted to nine
acute Geriatrics Units in Italy, France, Germany, Spain, Czech Republic,
The Netherlands and Australia were included in the study. In all
patients clinical and multidimensional information, including the
CGA-based MPI, were collected on admission and on discharge.
Results:
On admission all patients (mean age 84.7 ± 7.6 years and
prevalently females, 60.3% vs. 39.7%, p = 0.0001) were classified
according to the MPI score. The median MPI score improved
significantly from admission to discharge 0.63 vs 0.56, paired t
test = 0.004, respectively. Overall, the MPI score on discharge improved
in 35.25% of patients (mean age 83.81 ± 7.76 years), did not change in
38.13% of patients (mean age 84.43 ± 7.55 years) and worsened in
26.62% patients (mean age 86.20 ± 7.28 years), p for trend <0.001. No
significant differences were observed between men and women in
terms of improvement and worsening (Pearson Chi squared test,
p = 0.14).
Conclusions:
During hospitalization MPI score changes in most of
patients; these changes are age-related.
O-056
Dysphagia among the community dwelling elderly people: how
often? How we aware?
G. Bahat
1
, O. Yilmaz
1
, S. Durmazoglu
1
, F. Tufan
1
, C. Kilic
1
, M.A. Karan
1
.
1
Istanbul Medical School Department of Internal Medicine Division of
Geriatrics, Istanbul, Turkey
Aim:
Dysphagia is described a geriartric syndrome that occurs more
frequently with aging. This clinical problem is associated with
deterioration in functionality, malnutrition, infections, increase in
mortality and usually ignored. The prevalence of dysphagia in the
elderly among have been reported dysphagia is described a geriartric
syndrome that occurs more frequently with aging. This clinical
problem is associated with deterioration in functionality, malnutri-
tion, infections, increase in mortality and usually ignored. The
prevalence of dysphagia among elderly in many different populations
have been reported between 13,8% and 23,4%. In our country, a study
investigating the incidence of dysphagia have not been reported. In
this study, our aim is screening the prevalance of dysphagia among
elderly living in the community in our country.
Materials and methods:
The study includes patients admitted to our
clinic between July 2015 and March 2016, the patients ages were
between 60 and 98 years old and they were prospectively and
consecutively included in study. Dysphagia screening was done by
scanning the EAT-10 questionnaire. 2 separate threshold for EAT-10
score of dysphagia, threshold (3 or 15) was used. The patients
’
age,
gender, total disease, the total number of drug were noted. Dysphagia
awareness was investigated in patients with detected dysphagia. For
this purpose, dysphagia complaints, the patients were asked if they
would express dysphagia complaints when there is no screening
questionnaire.
Oral presentations / European Geriatric Medicine 7S1 (2016) S1
–
S27
S16