European Geriatric Medicine - Supplement 1 - Volume 7

Poster presentations

Area: Acute care

P-001

Treatment and outcomes of hip fracture in Lithuania, in 2010

M. Tamulaitiene, M. Jaramaviciene, J. Jaramavicius, V. Alekna.

Faculty of

Medicine of Vilnius University, Vilnius, Lithuania

Objectives:

To analyze the methods of treatment and outcome of hip

fractures in Lithuania.

Methods:

This population-based retrospective study was performed

collecting the data from all orthopaedic inpatient departments

in Lithuania. The records of subjects, who were hospitalized because

of primary hip fracture (ICD-10 codes S72.0, S72.1 and S72.2) at the

age over 40 years in 2010, were examined. Methods of treat-

ment were conservative and surgical, while the latter was divided

into fixation by screws, plate or intramedullary nail (IN), and total

hip arthroplasty (TA). The outcomes included death, transfer to

another department, discharge home or long-term hospital, and

rehabilitation.

Results:

In 2010, 2626 hip fractures occurred in Lithuania. The most

common method used was osteosynthesis: fixation by plate accoun-

ted for 41.4%, screw

–

21.1%), and by IN

–

in 3.4% of cases. TAwas used

in 25.9% and conservative treatment

–

in 8.1% of patients. After fixation

by screws, plates and IN, the majority of patients were discharged

home (42.5%, 35.8% and 37.8%, respectively) or to long-term care

hospital (24.5%, 22% and 32.2%, respectively). Otherwise, after TA,

70.1% of patients underwent rehabilitation. Among patients treated

conservatively, 39.7% were transferred to another department, ant

their mortality rate was highest (4.2%). Number of deaths was lowest

after treatment with screws (0.7%).

Conclusion:

In 2010, in Lithuania, the majority of patients with hip

fracture were treated with osteosynthesis using the external fixation.

Rehabilitation was more often outcome of treatment using total hip

arthroplasty, as compared to osteosynthesis.

P-002

Prognostic stratification of older adults in a geriatric day hospital

for acute care: comparison of four screening instruments

M.J.R. Aliberti

, S.Q. Fortes-Filho

, J.A. Melo

, C.B. Trindade

D. Apolinario

, W. Jacob-Filho

Division of Geriatrics, Department

of Internal Medicine, University of Sao Paulo Medical School,

Sao Paulo, Brazil

Objectives:

The identification of patients at high risk for adverse

outcomes plays an important role in medical acute care. We aimed to

compare the predictive values of four screening instruments in an

innovative model of Geriatric Day Hospital (GDH) in Brazil for older

adults with acute diseases.

Methods:

Prospective study that enrolled subjects aged 60 years and

older accessing a GDH over a 12-month period. Demographic data and

screening instruments (Identi

cation of Seniors at Risk [ISAR], Triage

Risk Screening Tool [TRST], Community Assessment Risk Screening

[CARS] and Silver Code [SC]) were administered at admission. Follow-

up by monthly telephone interviews was conducted within six

months to assess the outcomes (incident disability, emergency

department [ED] visit and hospitalization). The ability of each

screening instrument to predict outcomes at six months was esti-

mated using area under the receiver operating characteristic curve

(AUC).

Results:

Of 537 participants, mean (SD) age of 79.7 (8.4) years and 63%

female. The ISAR had a better performance in the AUC to predict

disability when compared to CARS (0.66 vs 0.59, p < 0.01) despite

being similar to others. The CARS had better AUC than ISAR (0.63 vs

0.57, p = 0.03) and TRST (0.63 vs 0.55, p < 0.01) in predicting ED visit.

Comparing with TRST, CARS (0.59 vs 0.52, p = 0.01) and ISAR (0.58 vs

0.52, p = 0.02) had a better prediction for hospitalization.

Conclusion:

The overall predictive power of the four screening instru-

ments assessed in an innovative model of GDH in Brazil was poor in

predicting adverse outcomes in older people at acute care.

P-003

Interface geriatrics

−

acute care for older people

E. Burns

, A. Cracknell

, F. Bell

Leeds Teaching Hospitals NHS Trust,

England, UK

Introduction:

Recent demographic changes have resulted in an

increased geriatric population emergency admission rate. These

patients are frail, older adults with multiple long-term conditions at

risk of multiple hospital admissions. The solution calls for an inno-

vative, multi-professional service to deliver person-centred care.

Method:

We developed a service offering consultant geriatrician

review in the emergency department (ED). In conjunction with the

early discharge assessment team ((EDAT)

–

team of nurses and

therapists) we perform an early comprehensive geriatric assessment

(CGA) beginning within the first hour of presentation. We utilised the

EDAT to assess mobility, provide equipment and integrate patients care

with community and social services. In addition, we altered patient

medications, treatment plans, initiated outpatient investigations and

arranged follow up clinics.

Results:

590 patients were seen and received CGA in our trial period.

58% were discharged from the ED, 27% were admitted to hospital

and 15% were admitted to due delays in arranging social care. For

comparison, baseline ED discharge rate is 20

–

25% (over 85 years) and

–

33% (75

–

85 years). We found no difference in readmission rates

for this group discharged from ED

–

18%, compared with the rate after

discharge from our Medicine for Older People wards

–

17%. Informal

feedback from patients and carers was largely positive.

Conclusion:

Our novel integrated acute care model has delivered high

quality early assessment to frail older people and developed good

multi-disciplinary working practices across traditional boundaries.

It has resulted in efficiency improvements in terms of appropriate

admission avoidance without increase in readmissions.

P-004

Safety and feasibility of percutaneous coronary intervention in the

elderly patients

N. Bendaoud, M. Saidane, A. Azouz, S. Seddiki, S. Latreche,

S. Benkhedda.

Algiers University, Mustapha Hospital

Background:

In parallel with increasing age in the north Africans

overall population we Remarque an increasing in the indication of

European Geriatric Medicine 7S1 (2016) S29 – S259

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