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

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9.9% of cases are newly diagnosed. 28.49% have a history of stroke
(20.82%) or TIA (6.84%) or TIA + stroke (0.83%). Chronic kidney disease:
background (11.8%), and discharge (34.4%). Hospital mortality:
18.9%. Treatment at income: 56.83% acenocoumarol, warfarin 5.16%,
7.29% NOACs (rivaroxaban 80%), ASA 24.62%. Anticoagulation cri-
teria: CHADS2 ≥ 2 (96.7%), CHA2DS2-VASC≥ 2 (99.7%), HASBLED ≥ 3
(44.1%). Complications: bleeding (6.3%), anaemia (49%), stroke (6.8%).
Conclusion: Low prevalence of atrial fibrillation than described for
this age range. Low incidence of atrial fibrillation in the study sample.
High hidden chronic kidney disease in the studied group. According to
the guidelines for use of oral anticoagulation (NICE, EHRA) patients
met the criteria for oral anticoagulation.
P-020
Description and monitoring of elderly patients candidates for
intensive care
I. Ferrando Lacarte1, M. Gonzalez Eizaguirre1, C. Deza Perez1, C. Canovas
Pareja1, J.I. Corchero Martin2, E. García-Arilla Calvo1. 1Geriatrics,
2ICU Services, Hospital Nuestra Señora de Gracia, Zaragoza, Spain
Objetives: To describe characteristics of patients older than 80 years
admitted to ICU and monitoring resource use and mortality.
Method: Prospective descriptive study of ICU admissions between
2012 and 2014. Evolution and monitoring during first year.
Results: 142 patients. 22.36% of total incomes. Distribution by years:
2012: 19.32%, 2013: 22.54%, 2014: 56.3%. 25.90% Men. Average age:
83.65 years (80–93). 8 over 90 years. Apache II: 12.62 (4–38). Average
stay: 6.57 days. Admission from: Emergency 79.6%, 11.3% medical
services, 4.2% surgical services, other ICUs 4.9%. Income diagnosis:
41.9% acute coronary syndrome, 25.8% rhythm disorders, 6.5% heart
failure, 4.8% respiratory insufficiency, 4% cardiorrespiratory arrest,
4% sepsis, pneumonia 3.2%, 1.6% pulmonary embolism. Background:
19.7% atrial fibrillation, ischemic heart disease 26.8%, valvular disease
14.8%, hypertension 79.6% 18.3% I heart, I chronic renal 12%, chronic
respiratory 12.7% I, ACV 16.9%, 8.5% cognitive impairment, DM 26.8%,
14.1% COPD. Complications: 14.8% nosocomial infection, Delirium
17.6%. ICU mortality: 22.5%. One-year mortality: 26.4% During first
year: attending emergency department 1 or 2 times 41.8%, >3: 19.1%.
(39.1% do not need emergency services). 40% require 1 or 2 hospital
admissions, >3: 10%. (50% do not enter). A patient was readmitted to
the ICU (0.1%).
Conclusion: High prevalence of elderly patients who need intensive
treatment, with a growing number of income in subsequent years.
Predominant cardiac pathology. Regardless of age are candidates
for invasive techniques. Low cognitive impairment and delirium.
Moderate mortality during hospitalization and first year. High use of
emergency services, not requiring income in half the cases.
P-021
Combining brief physical and cognitive assessments to predict
hospitalization and functional decline in elderly outpatients in
acute care
S.Q. Fortes-Filho 1,2, M.J.R. Aliberti2, J.A. Melo1,2, D. Apolinario2,
W. Jacob-Filho2, L.E. Garcez-Leme1,2. 1Department of Orthopedics and
Traumatology, University of São Paulo Medical School, São Paulo, Brazil,
2Division of Geriatrics, Department of Internal Medicine, University of São
Paulo Medical School, São Paulo, Brazil
Objectives: To evaluate the predictive value of combined short phy-
sical performance battery (SPPB) and 10-point cognitive screener
(10-CS) for hospitalization and functional decline, defined as a decline
at least one activity of daily living.
Methods: A 6-month prospective cohort study with 383 older adults
who were able to walk and without previous diagnoses of dementia
admitted to a Geriatric Day Hospital (GDH) with acute problems in
São Paulo, Brazil. Poor physical performancewas defined as SPPB lower
than seven points and provable cognitive impairment when 10-CS
lower than seven points (maximum of 10). High-risk group were
patients who had poor performance in both assessments and
medium-risk group those with poor performance in at least one test.
Kaplan-Meier curves and adjusted Cox proportional hazards models
were calculated for each outcome.
Results: The 6-month incidence of hospitalization and functional
decline were significantly more frequent in the high-risk group at
Kaplan-Meier curves (p = 0.001 and p < 0.001). After adjusting for
demographic and clinical variables, participants with high-risk
and medium-risk were more likely to hospitalization (HR = 2.5; 95%
CI 1.4–4.5 and HR = 1.9; 95%CI 1.2– 3.1, respectively) compared with
participants with a low risk. High-risk and medium-risk group were
also independently associatedwith functional decline (HR = 5.7; 95%CI
2.6–12.3 and HR = 4.3; 95%CI 2.1–8.8, respectively). The Harrell’ s C
discrimination index was 0.65 for hospitalization and 0.74 for
functional decline.
Conclusion: In acute care older patients admitted at GDH, combining
brief physical and cognitive assessments was a good predictor of
hospitalization and functional decline in six months.
P-022
Older adults in the emergency department: the challenge of
undertriage
B. Gasperini1, A. Fazi2, A. Cherubini3, G. Maracchini2. 1Department of
Geriatric and Rehabilitation, Santa Croce Hospital, Azienda Ospedaliera
Ospedali Riuniti Marche Nord, Viale Vittorio Veneto 2, 61032 Fano, Italy,
2Emergency Department Ospedale Principe di Piemonte, Asur Marche
Area Vasta 2 Via Cellini 1, 60019 Senigallia, Italy, 3Geriatrics and Geriatrics
Emergency Care, Italian National Research Center on Aging
(IRCCS-INRCA), Ancona, Italy
Objectives: Older adults are vulnerable patients at risk of undertriage.
We aimed at evaluating the undertriage rate and associated risk factors
in an Italian Emergency Department (ED).
Methods: A retrospective study carried out on subjects 65 years and
older. Undertriage is defined as a priority tag assigned at admission
lower than the severity tag assigned at discharge.
Results: 8894 subjects >64 years were admitted in 2012. 675 cases
(7.6%) underwent undertriage, 9.2% among over 85 years, 7.5% to
84–75 years and 6,4%, to 65– 74 years (p < 0.001). The mean age in
the undertriage group was 79,8 years compared to 78.5 years
(P < 0.001). The length of stay between acceptance and visit was 105
minutes vs 80 minutes (p = 0.001). Undertriage was associated with
“unspecified complaints ” in 33.5%, dyspnoea (10.5%), trauma (11.4%)
and pain (excluding abdominal and chest) (7.6%) as admission
complaints. At discharge 15% kept a diagnosis of “unspecified ill
conditions”. 72% of older adults with undertriage were hospitalized
compared to 22.7% of the others (p < 0.001). Risk factors were
age greater than 74 years (OR 1.429, CI 1.167–1.750), and 84 years
(OR 2.291, CI 1.839–2.853) and admission for wheezing (OR 2.751, CI
2.046–3.699). Admission for trauma was protective (OR 0.522, CI
0.406–0.671; p < 0.001).
Conclusion: Undertriage determined delayed care and older age is an
important risk factor. The high rate of diagnosis of unspecified disease,
both at the triage and at discharge, underlying the troubles in focusing
the real clinical problem in older patients.
P-023
Standby resuscitation for elderly patients: how to guess the
outcome?
R. Legrand, P. Gillois, J.F. Payen, G. Gavazzi, T. Trouve Buisson. University
of Grenoble-Alpes and University Hospital of Grenoble-Alpes, France
Introduction: Elderly patients admitted in intensive care units have
more severe outcomes than general population. Standby resuscitation
is devoted to avoid lost of opportunity and unreasonable obstinacy
when prognosis is uncertain. This study aimed to determine prognosis
factors associated with in hospital survival after 3 days in ICU.
Methods: Retrospective study including all patients >80 years old
admitted in ICU between 2012 and 2014. Clinical status, diagnosis,
organ failures characterized by severity scores (IGS II, SOFA) at
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S34