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

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and patients >80 yo had a longer TAD (mean 8:01 vs 7:40 hours), but
the difference was not significant.
Key Conclusions: Patients over 80 years old present with even less
specificity in PE. Nevertheless, MTS color was not influenced by old
age, allowing for an equally fast imaging diagnosis of PE.
P-016
Outcome of older patients admitted in an Internal Medicine
ward – results of a cohort of 100 patients at discharge, 6 and
12 months follow-up
Á. Chipepo 1, S. Duque2,3, M.J. Serpa1, M. Maia1, Y. Mamade1, A. Watts
Soares 1, S. Velho4, F. Araújo1, J. Pimenta da Graça1. 1Internal Medicine
Department, Hospital Beatriz Ângelo, Loures, 2Internal Medicine
Department, Centro Hospitalar de Lisboa Ocidental, Hospital São
Francisco Xavier, 3Unidade Universitária de Geriatria, Faculdade de
Medicina, Universidade de Lisboa, Lisboa, 4Nutrition and Dietetics
Department, Hospital Beatriz Ângelo, Loures, Portugal
Introduction: In-hospital mortality is one of the quality indicators
most used worldwide. However, in older people this quality indicator
do not exactly reflect life expectancy nor quality of life after discharge.
Healthcare professionals and stakeholders are not aware of the
medium/long-term outcome of patients discharged. Our aim was to
evaluate mortality, readmissions and emergency department (ED)
admissions at 6 and 12 months (6 M, 12 M) follow-up of patients ≥75
years admitted to an Internal Medicine (IM) ward.
Methods: Prospective longitudinal cohort study of 100 patients.
Comprehensive geriatric assessment at baseline was performed.
Outcome at 6 M and 12 Mwas assessed by phone contact and hospital
record analysis.
Results: Average age 83.7 years, 63% males, 25% nursing home
residents, average Cumulative Illness Rating Scale Geriatrics 11.2,
average Barthel score 62.6, 70% malnourished, 31% cognitively
impaired. In-hospital mortality 10%. One patient lost during follow-
up. Considering follow-up of 89 patients at 6 M and 12 M: mortality
42.7 and 48.3% (51 survivors at 12 M); 39.3 and 47.2% of patients
were readmitted; 60.7 and 66.3% of patients were admitted in ED.
Mortality, readmission and ED admission rates were expressively
lower during the 2nd semester of follow-up: 9.8, 23.5, 41.1%. Survivors
revealed expressively lower readmission and ED admission rates at
6 M and 12 M, comparing to non-survivors.
Conclusions: Mortality of older people discharged from an IM ward
is impressively high, namely in first 6 months. Readmission and ED
admission rate might be markers of poor outcome. Further analysis
of high-risk patients is needed to understand the predictability of
mortality.
P-017
Stroke and intravenous thrombolysis in patients 80 years and older
C. Eira 1, Â. Mota1, R. Silvério1, A. Gomes1, A. Monteiro1. 1Tondela-Viseu
Hospital Center, Viseu, Portugal
Objectives: Cerebrovascular disease is the leading cause of death in
Portugal. Intravenous thrombolysis is a breakthrough in the treatment
of ischemic stroke. Clinical trials rarely include patients greater than
80 years old. Therefore, the risks and benefits of thrombolysis in this
age group remains uncertain.
Methods: A retrospective study was performed on patients ≥80 years
old admitted to a Stroke Unit between 2009 and 2015 with ischemic
stroke. All patients underwent intravenous thrombolysis. The study
evaluated demographic, clinical and functional outcome. Statistical
analysis was performed using SPSS.
Results: A total of 285 thrombolysis were performed, 60 (21.1%)
of which in patients ≥80 years old. A majority of the patients
were female (68.3%). The mean age was 83.3 years old. The main
comorbidities were hypertension (70.0%) and atrial fibrillation (65.0%).
Most strokes occurred in the anterior circulation (96.7%). Computed
tomography showed signs of acute ischemia in 53.3%. In 76.7% of
the cases, thrombolysis was performed in the first 3 hours of onset of
symptoms. Intravenous antihypertensive medication was used
in 6.7% of cases. Cardioembolic strokes were more prevalent
(63.3%). Intracranial bleeding occurred in 16.7% of patients and 28.3%
had no neurological complications. At hospital discharge, 36.7% of
patients had Modified Rankin Scale (MRS) ≤ 2. The mortality rate
was 18.3% (11 patients). At 3 month follow-up 20.4% had died and
40.8% had mRS ≤ 2.
Conclusion: Intravenous thrombolysis should be performed in selec-
ted patients. The prognosis depends on the age, stroke severity,
comorbidities and non-neurological complications.
P-018
Incorporating the OPERA instrument to identify and direct the care
needs of frail older patients in the AMAU Setting
A. Fallon, R. Moola, J. Armstrong, R. Briggs, T. Coughlan, D. O’Neill,
R. Collins, S.P. Kennelly. Tallaght Hospital
Background:Frail older patients represent an increasing proportion of
those accessing acute hospital services. The aim of this study was to
evaluate outcomes for patients aged ≥70 presenting to the acute
medical assessment unit (AMAU) based on functional ability scores on
admission.
Methods: A prospective cohort study was carried out. Data was
collected on patients presenting between July 2015 and May 2016.
Functional ability (FA) is routinely recorded as part of a novel 5-minute
nurse-administered instrument- the Older Persons in ED/AMAU Risk
Assessment (OPERA) for those aged ≥70 admitted to the AMAU.
The Delphi-derived OPERA instrument reviews premorbid comorbid
illness, functional ability (Mobility, self-care, speech and nutrition),
and acute illness indicators. FA needs were calculated as a score of 0
(independent) – 7 (dependent). A positive response to each question
directs MDT referral to appropriate specialty for review.
Results: 1952 patients attended AMAU during this period. 28.4%
(555/1952) were aged ≥70. 44.3% (246/555) scored 0 on FA. 18.1%
(100/555) scored 1, 10.5% (58/555) scored 2, 10.2% (57/555) scored 3,
9.2% (51/555) scored 4, 5.7% (32/555) scored 5, 3.6% (20/555) scored 6
and 3.6% (20/555) scored 7. 956 MDT referrals were prompted. 70.3%
(390/555) were admitted. The highest admission rate, 95% (19/20), was
in the FA6 group, 20% (4/20) of whom were nursing home residents
and a further 10% (2/20) were newly discharged to nursing homes.
No patients in the FA1 group were discharged to nursing homes; 84%
(84/100) went directly home. Average length of stay increased in each
category from 6.4 (0–52) days in the FA1 group to a maximum of 17.2
(2–125) days in the FA5 group. The highest in-hospital mortality rate
was in the FA5 group, 15.6% (5/32).
Conclusions: The OPERA instrument was easily incorporated into
admission process and supported early referral to MDT services for
timely intervention.
P-019
Non-valvular atrial fibrillation: drugs used for stroke prevention
I. Ferrando Lacarte, B. Gamboa Huarte, C. Deza Perez, M. González
Eizaguirre. Geriatrics Service, Hospital Nuestra Señora de Gracia,
Zaragoza, Spain
Objectives: Atrial fibrillation is highly prevalent in geriatric popula-
tion. We set as objetives to describe drugs used for prevention of
thromboembolic events (ASA, clopidogrel, VKAs, NOACs) in a sample
of patients discharged from a Geriatrics Service in 2015.
Methodology: We reviewed discharge reports and electronic medical
records of hospital discharges with a diagnosis of atrial fibrillation.
Variables studied: sociodemographic (gender, age), clinical (income
days, personal history, renal function, Charlson index (CI), Barthel
index (BI), SPMSQ, CHADS2, CHA2DS2-VASC, HASBLED, liver function,
antiplatelet drugs and anticoagulants, albumin, coagulation study),
associated complications (stroke, anemia, bleeding), hospital mortal-
ity. SPSS v19.
Results: 1379 patients were discharged in 2015, 365 (26.46%) diag-
nosed with atrial fibrillation. Women 67.9%. mean age 87.41 (71– 102).
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S33