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

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There is limited research surrounding the psychosocial needs of men
diagnosed with prostate cancer.
Methods: Demographic questionnaires and focus groups were used
with a sample of 16 Portuguese men aged between 49 and 81 years.
Results: The psychosocial and psychosexual impact of this disease is
influenced by a number of factors including medical factors, individual
factors, and relationship factors. Overall, prostate cancer treatments
(medical factors) did not disrupt sexual functioning or body image.
Instead, hopelessness and fatigue (individual factors) were found to
impact men ’s sexual functioning, and depression was related to men’ s
own body image as well as how he perceived his female partner to
view his body. Finally, men’s perceptions of their female partners ’ view
of their bodies (relationship factor) were related to the men’s own
body image and marital satisfaction.
Conclusion: Findings suggest a more positive view regarding the
anticipated negative consequences of a prostate cancer diagnosis.
P-834
Latest trends in home care rehabilitation in knee prosthesis: a
systematic review
R. López-Liria 1, F.A. Vega-Ramírez1, D. Catalán-Matamoros1, A. López-
Villegas1. 1University of Almería, Almería, Spain
Objective: to analyze the existing studies on home care rehabilitation
and physiotherapy in patients with a knee prosthesis intervention in
the last 10 years.
Methods: this review identifies and synthesis the results of the
interventions measured in terms of muscular strength, function,
patient’ s quality of life and cost of the service, compared with other
alternative treatments. The databases analysed were CUIDEN,
PUBMED and PEDro.
Results: in relation to the systematic review, it has been proofed that
there exists many international studies with good level of scientific
evidence that provide a grade of “favourable recommendation” for
the domiciliary physiotherapy in the treatment of knee prosthesis
compared with traditional ambulatory physiotherapy. One of the more
relevant characteristics of the domiciliary physiotherapy is that it is
developed in a different environment and it is well accepted by the
users. It gives people protection against comorbidities, service access,
at the same time that it lets patients increase their capacities with the
same effectivity than those offered in the traditional system aimed to
improve functional and social autonomy. It has been proved a good
capacity for the detection of risk groups, moveless, very dependent
and with high morbidity that it has been converted in the main goal of
these interventions in home rehabilitation.
Conclusions: Although there exist clear needs for increasing the
number of studies based in the scientific evidence in relation to the
domiciliary physiotherapy, due to that the studies are mostly based in
observational studies, reviews and experts opinions including much
variability and limitations.
P-835
Outcomes after hip fracture in patients aged 90 and older
L. Meadows, O. D’ Souza, D. Watkin. York Hospitals NHS Foundation Trust
Introduction: The populations of industrialised countries are ageing,
with subsequent increases in the number of people living with frailty,
dependency and disability and the consequent need for costly nursing
and social care. Falls and hip fracture are a common cause of
hospitalisation in elderly people and result in significant disability,
morbidity and mortality [1, 2]. Outcomes for patients undergoing
surgery for hip fracture in the UK are well established through the
National Hip Fracture database [3]. Knowledge about outcomes
including survival, functional status and walking ability in the
nonagenarian subgroup is limited [4 –7].
Methods: 50 nonagenarian patients admitted with hip fracture to
Scarborough Hospital were identified using the hospital ’ s hip fracture
database. All fracture types were included. Patient medical, operative,
physiotherapy and occupational therapy records were retrospectively
reviewed. 48 patients underwent surgery and all followed a similar
post operative protocol with mobilisation on the first day if possible,
regular orthogeriatric review, and low-molecular weight heparin
administration for 1 month post operatively. Time to surgery, ASA
grade, operative procedure and length of stay were recorded. The
patients’ pre and post-operative mobility and place of residence were
defined. 30 day and 120 day mortality was calculated.
Results: We identified 37 females (mean age 93.5 years, range 90–100)
and 13 males (mean age 93.2 years, range 90– 100). Of these 48
underwent surgery to repair a hip fracture. A total of 16 patients (32%)
died during followup. 30 daymortality was 16% (8 deaths) and 120 day
mortality was 28% (14 patients). The mean time to surgery was 27.21
hours (range 4.92–117.08). Average length of stay was 30.32 days
(range 2–59). The median ASA scorewas 3 (60% of patients undergoing
surgery) reflecting indicators of poor health status in this group. 20
patients (42% of the patients who underwent surgery) received spinal
anaesthesia and 25 patients (52%) received a general anaesthetic.
Conclusions: The outcome of surgical management followed by
rehabilitation for nonagenarians presenting to Scarborough Hospital
with hip fractures is favourable in selected patients despite
many having multiple co-morbidities and high anaesthetic risk.
Patients aged 90 years or older with hip fracture achieve surprisingly
good outcomes and many are able to return home with preserved
independence after operative intervention and appropriate
rehabilitation.
References
1. Gill TM, Allore HG, Holford TR, Guo Z. Hospitalization, restricted
activity and the development of disability among older persons.
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2. Brenneman SK, Barrett-Connor E, Sajjin S, Markson LE, Siris ES.
Impact of recent fracture on health-related quality of life in
postmenopausal women. J Bone Miner Res 2006;21:809–16.
3.
4. Kauffman TL, Albright L, Wagner C. Rehabilitation outcomes after
hip fracture in persons 90 years old and older. Arch Phys Med Rehabil
1987;68:369–71.
5. Shah MR, Aharonoff GB, Wolinsky P, Zuckerman JD, Koval K.
Outcome after hip fracture in individuals ninety years of age and
older. J Orthop Trauma 2001;15:34–9.
6. Holt G, Smith R, Duncan K, Hutchison JD, Gregori A. Outcome after
surgery for the treatment of hip fracture in the extremely elderly.
J Bone Joint Surg Am 2008;90(9):1899–905.
7. Formiga F, Lopez-Soto A, Sacanella E, Coscojuela A, Suso S, Pujol R.
Mortality and morbidity in nonagenarian patients following hip
fracture surgery. Gerontology 2003;49(1):41 –5.
P-836
Validity of three risk prediction models to predict 1-year mortality
in hip fracture patients
R. Menéndez-Colino1,3, J.I. González-Montalvo1,3,4, T. Alarcón1,3,4,
R. Queipo2,3, A. Otero2–4. 1Geriatrics Department, Hospital Universitario
La Paz, 2Preventive Medicine Department, Universidad Autónoma de
Madrid, Madrid, Spain; 3IdiPAZ, 4RETICEF
Introduction: Mortality is high after hip fracture (HF). It is useful to
know what patients are in a higher risk of mortality in order to
implement preventive interventions. Several scoring instruments have
been applied to predict this mortality risk.
Objective: To identify the most accurate predictor of one-year morta-
lity following HF.
Methods: In a sample of 509 consecutive HF patients admitted at
an acute Orthogeriatric Unit University Hospital three prognostic
scores (Abreviated Charlson Index -AChI-, American Society of
Anesthesiologists –ASA- Scale, and The Nothinghan Hip Fracture
Score – NHFS-) were applied in the first 72 hours from admission. Cut-
offs were >2 for ASA, >2 for AChI and >4 for NHFS. Patients were
assessed for survival 1 year after discharge.
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