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

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and the British Orthopaedic Association recognises the importance
of the FIB. Increasing evidence shows the FIB improves patient ’ s
rehabilitation by giving quick and effective pain relief.
Methods: We retrospectively examined the clinical notes of patients
admitted with a fractured neck of femur (NOF) for evidence of FIB,
whilst also recording the frequency of administration of opioid
analgesia. 98 patients were admitted with a NOF between July and
end of September 2015. Paper and electronic notes were examined
and evidence of FIB was identified. The Length of hospital stay, amount
of codeine phosphate andmorphine sulphatewere all noted. The notes
of outliers were examined in further detail in order to aid our
discussion.
Results: Overall, 21/98 patients did not have clinical notes available.
Of those accessible, 50/77 patients received a FIB and 27/77 did not.
The mean length of inpatient stay was reduced by 2 days in patients
receiving FIB. Postoperative Oral morphine solution was higher in
the population who received a FIB. However, for some of these
patients there were other medical reasons for increased analgesia
requirements.
Conclusion: Using a FIB allows early and effective pain control. This
prevents pre-operative and post-operative complications, helps
patients to mobilise early and hence an earlier discharge.
P-830
The intersectoral treatment and prevention path for geriatric risk
patients
L. Kasprick 1,3, K. Zimmer2, S. Feist1, S. Liebmann1. 1GeriNet Leipzig,
2Geriatrische Schwerpunktpraxis Katrin Zimmer, 3InGrA
Objectives: Whether in a hospital or in a general practice, patients and
their families need an individual supply and care plan during, before
and after hospital stay. The individualized treatment-path is adaptable
and depends on the individual need for assistance. Over the past
decades, age structure has changed dramatically. Multimorbidity and
increase of physical and mental impairments are typical signs. As a
consequence, the uncertainty of walking rises with higher risk of
falling and nevertheless, there are limitations in the activities of daily
living. More than 50% of patients in acute care and emergency
departments are older and multimorbid. In order that, there are
individual, complex and long-term problems that threaten patient ’ s
autonomy, respectively. In comparison to younger people, the
probability to get sick or fall is very high. In addition, there are
increased declines in mobility and cognition as a consequence of the
physiological age processes. These factors are directly related to
autonomous action in everyday life of older people and affect quality
of life during inpatient and outpatient setting.
Methods: A special “Bewegungs- und Kognitionsgruppe” into the
geriatric “Schwerpunktpraxis”
Results: The aim of this study was to determine, whether training of
mobility and cognitive function has potential to improve quality of life
of older, multimorbid patients during a stay in acute geriatric hospital
and in a special “Bewegungs- und Kognitionsgruppe” into the geriatric
“Schwerpunktpraxis”.
Conclusion: The aim of this intersectoral medical, nursing and
therapeutic study was to improve the individual quality of life. This
may involve an increase in the ability to help themselves, reduction of
long term care and a reduction of medicine usage.
P-831
Endoscopic retrograde cholangiopancreatography (ERCP) for the
elderly and extremely elderly
M. Kopke Túlio 1, L. Carvalho1, S. Marques1, J. Carmo1, J. Rodrigues1,
B. Charrua1, P. Barreiro1, T. Bana e Costa1, C. Chagas1. 1Gastroenterology
Department, Egas Moniz Hospital, Lisbon, Portugal
Objectives: To assess ERCP safety and effectiveness in elderly patients.
Methods: Clinical data from patients >85 years-old that underwent
ERCP during a two year period was analyzed. Sample divided in elderly
(85–90 years-old) and extremely elderly (>90 years-old).
Results: 147 duodenoscopies were performed, 98 in elderly and 49 in
extremely elderly patients. Most frequent diagnosis were lithiasis
(61,2%) and neoplastic stenosis (27,9%), with 8,5% of normal exams.
There was a 93% cannulation rate, in 15,5% after precut papillotomy or
guidewire placement. Juxtapapillary duodenal diverticula identified in
20,4%. Immediate complications present in 7,7% of patients, namely
bleeding (9) and bradycardia (1), with bleeding episodes managed
endoscopically and only 1 case needing transfusion. Delayed compli-
cations (in 99 patients with 30days follow-up) identified in 2% of
patients, namely cholangitis (1) and gastrointestinal perforation (1),
treated endoscopically, with no cases of post-ERCP pancreatitis.
Mortality occurred in 4 patients (4%), with only 1 case due to ERCP
(cholangitis/sepsis). There was an association between cannulation
rate and presence of juxtapapillary diverticula (p = 0,002) and
between immediate bleeding and precut execution (p < 0,001). No
association identified between immediate bleeding and previous
antiplatelet/anticoagulant therapy (p = 0,771) or between age groups
and presence of immediate (p = 0,817) or delayed complications
(p = 0,071).
Conclusions: ERCP was safe and effective in both elderly and
extremely elderly patients. Presence of juxtapapillary diverticula was
a negative predicting factor for a successful exam, whereas precut
execution was associated to immediate bleeding. Age and previous
treatment with antiplatelet or anticoagulant agents were not
associated to increased risk of complications.
P-832
Reducing pneumonia and delirium in hip fracture patients by
implementation screening for dysphagia
R.L. Kriekaart1, T.T. Boom2, E.J. Hekma3, L. Roovers4, H.H. Wijnen1.
1Geriatrics, 2Orthopedics, 3Traumatology, 4Biostatistics, Rijnstate
Hospital, Arnhem, the Netherlands
Introduction: Pneumonia is an important cause of hospital mortality
in frail patients after hip fracture surgery. A recent study suggests a
high prevalence of oropharyngeal dysphagia (OD) in these patients
[Love et al. 2013]. We hypothesized OD-screening would decrease
post-operative pneumonia in hip fracture patients, as it does in
patients after cerebrovascular disease [Brady et al. 2016].
Methods: Data were collected for a retrospective cohort study
including all post-operative hip fracture patients on an orthogeriatric
ward in Rijnstate hospital. The control group consisted of patients
admitted from January 2013 until November 2014. All patients from
November 2014 until December 2015 were screened for OD (inter-
vention group). Data were extracted from electronic patient records
including age, sex, frailty, death during admittance, diagnosis delirium
and pneumonia .
Results: 814 patients were included. The control group consisted of
481 patients, average age 83.4 years ± 6.6, average ASA score 2.6 ± 0.7
and 18.5% living in a nursing home. In the intervention group 333
patients were included, average age 83.7 years ± 7.2, average ASA score
2.5 ± 0.7 and 16.0% living in a nursing home. In comparison to the
control group OD screening resulted in a significant reduction of
pneumonia from 10.4% to 5.7% (p < 0.05) and a reduction in delirium
from 42.6% to 28.5%(p < 0.05). In-hospital mortality decreased from
4.2% to 2.7% (not significant).
Conclusion: OD-screening resulted in a significant decrease of
pneumonia and delirium. It seems plausible that this screening
could be a potent intervention to reduce pneumonia and delirium in
frail elderly after hip fracture surgery.
P-833
Impact of prostate cancer on body image: a descriptive approach
C. Laranjeira. RECI I&D – Piaget Institute, Viseu, Portugal
Objectives: Receiving a diagnosis of cancer can be very difficult and
emotionally challenging for patients and their families. The diagnosis
and treatment of prostate cancer impacts a man on many levels. Men
often experience a wide range of psychological and sexual difficulties.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S248