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

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was a higher number of medical complications in patients undergoing
surgery after 48 hours (80.9% vs 70.1%, p = 0.009), specially urinary
infection (30.3% vs 20.8%, p = 0.03) and pressure sores (14 vs 6.5%,
p = 0.017) with a trend for increased frequency of delirium (47.1% vs
39.6%), respiratory infection (15.6% vs 11.7%) and renal failure (15.6% vs
12.3%). This group also had a higher number of comorbidities (3 ± 2,
p = 0.002), higher mortality (4.8%vs 2.6%, p = 0.26) and longer length of
stay (15.5 vs 11.5 days, p = 0.34).
Conclusions: In our population, the group of patients undergoing
surgery later than 48 hours from admission has higher comorbidity
and medical complication rates (mainly, urinary infection and
pressure sores).
O-078
Osteoporosis treatment after hip fracture: predicting survival with
Nottingham scale
M. Macias 1, L. Hunicken1, A. Sow1, M. Guerrero1, A. Muñoz1. 1Geriatric
Unit, Hospital General de Segovia, Segovia, Spain
Objectives: As treatments for osteoporosis need time to reduce
fracture risk, they should be guaranteed to patients with high survival
probability.
Methods: Prospective data were collected from patients admitted for
hip fracture surgery. Anayses were conducted using the software
package SPSS 15, using Chi-square test and U Mann Whitney when
appropiatte P values <0.005 were considered statistically significant.
Results: Among 198 patients over 75 years, 151 (76%) had surgery.
Mean age was 87+/−6.5 years, mean Barthel index prior to admission
was 69.84+/ −28; mean risk of osteoporosis by Q-FRACTURE scale was
5.56+/ −2 points; mean preoperative stay was 4.47+/−3 days and mean
hospital stay was 11.70+/−6 days In hospital mortality rate was 5.6%
(1.32% post surgery) and statistically related with the number of
complications, previous mobility (Parker scale) and pre surgery
comorbidity (Charlson scale), Mortality rate after 1 month follow up
15% was associated with age, number of complications, Charlson,
Barthel index at discharge and Nottingham score. Mortality rate after 1
year follow up 29% was associated with age, Barthel index prior to
fracture and at discharge, Charlson, Nottingham and Q-fracture. In
multivariate analysis the best predictor of mortality was Nottingham
score
Conclusions: 30% 1 year mortality in eldely hip fracture patients is
mainly related with functional level and comorbidity. As Nottingham
is the best predictor of mortality, all patients with. low scores should
receive osteoporosis treatment.
Area: Acute care and healthcare organisation
O-079
Hospital admissions of community-dwellers and residents in long-
term care (LTC): Debunking a myth
B. Ok 1, J.B. Broad1, X. Zhang 1, M. Boyd1,2, M.J. Connolly1,2. 1University of
Auckland, 2Waitemata District Health Board, Auckland, New Zealand
Introduction: Hospitalisation rates from nursing homes in UK,
Australia and Scandinavia are up to double those of community-
dwellers. Hospitalisations from LTC residents are not described for
New Zealand. Our aim was to compare hospitalisation rates of LTC
residents with those of community-dwelling older people.
Methods: National databases provided information for publicly-
funded hospitalisations in Auckland. Age- and gender-specific
annual hospitalisation rates for LTC residents were estimated based
on residents included in the OPAL survey [1,2], and by subtraction for
community-dwelling residents. The Australia Refined Diagnosis
Related Groups v5.0 definitions categorized admissions into selected
disease groupings.
Results: 73,514 hospitalisations occurred from the population of
129,870 aged 65+ years. Annual age-standardised admission rates for
the population aged 65+ were 54.9 [95%CI: 52.1,57.8] per 100 person-
years for LTC residents and 60.2 [95%CI: 59.8,60.7] per 100 person-
years for community dwellers. Hospitalisation rates rose markedly
with age among community-dwellers, but not for LTC residents. Men
were admitted more thanwomen across all age groups of community-
dwellers, but not for LTC residents. LTC residents were hospitalised less
than community-dwellers overall (particularly for surgical or other
planned procedures, for ear, nose and throat, and circulatory
disorders). For disorders of the urinary tract, respiratory and nervous
systems they were hospitalised more often.
Key conclusions: Hospitalisation rates from LTC were lower than
community-dwellers, contrasting with overseas reports. Findings
from one country may not apply in other health systems; results of
intervention studies are therefore not necessarily generalisable.
References
[1] Broad JB et al. Age Ageing 2011;40(4):487–94.
[2] Boyd M et al. J Am Med Dir Assoc 2011;12(7):535–40.
O-080
Is self-rated health an independent prognostic factor of six-week
mortality in older patients hospitalized for an acute condition?
L. Godaert1, C. Godard-Sebillotte2, T. Basileu1, J.-L. Fanon1, M. Dramé3,4 .
1University Hospitals of Martinique, Department of Geriatrics, Fort-de-
France, Martinique; 2McGill University, Department of Family Medicine,
Montreal, Canada; 3University of Reims-Champagne, Faculty of Medicine,
EA 3797, 4University Hospitals of Reims, Department of Research and
Public Health, Reims, France
Purpose: To determinewhether self-rated health is a prognostic factor
of six-week mortality, independently of other known objective
prognostic factors.
Methods: The SAFMA study was a prospective cohort, which recruited
patients from the University Hospital of Martinique Acute Care for
Elders unit (French West Indies) from January to June 2012. Patients
aged 75 or older and hospitalized for an acute condition were eligible.
The outcome was time to death within the six-week follow-up.
The main explanatory variable was self-rated health.
Sociodemographic and clinical characteristics were considered as
covariates. Cox’s Proportional Hazards model was used.
Results: Among the 223 patients included, mean age was 85.1 ± 5.5
years. Six-week mortality rate was 14.8%; none were lost to follow-up.
In total, 123 claimed “very good to good” health, and 100 “medium to
very poor” health. Self-rated health was the only independent
prognostic factor associated with six-week mortality (Hazard Ratio:
2.61; 95% Confidence Interval: 1.18–5.77; p = .02), when adjusting for
known prognostic factors such as age, and dimensions of the
Comprehensive Geriatric Assessment or comorbidity.
Conclusion: The association between self-rated health and short-term
mortality could have implications for clinical practice, particularly in
helping in the estimation of prognosis in acute care setting.
O-081
Should we reconsider the management of the elderly polytrauma
patient?
J.C. Lane, S. King, G.E.R. Thomas, K. Willett, K. Shah. Trauma Service,
John Radcliffe Hospital, Oxford, UK
Introduction: As the population ages and survivorship of initial
traumatic injuries increase, there may a larger group of elderly patients
presenting with polytraumatic injury. This prospectively collected,
retrospectively analysed study aimed to investigate the incidence,
management and outcome of elderly patients presenting with
polytraumatic injury.
Methods: Consecutive patients presenting to one major trauma centre
in the UK with an injury severity score (ISS) of over 9 were
prospectively collected over a 30-month period. Multivariate analysis
Oral presentations / European Geriatric Medicine 7S1 (2016) S1–S27 S23