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and poisoning [21,4%], discharge to home [81,6%] and the means

length of stay of 178 minutes. The younger were used more the green

color of triage [24.3% vs. 16.1%] while the older used the orange color

[13.9% vs. 7.3%] statistically significant (p = 0.0001). For discharge to

home, the younger had a higher utilization [85.6% vs. 73.7%] and the

older was more than three times as great as for admission to ward

[RR = 3.01] fifteen times for mortality [RR = 15,73] and four times to

transfer to another facility [RR = 4,64]. Finally, the length of stay was

more high for older [219 vs 157 minutes; p = 0.0001], associated a high

severity [14.4% vs 7.5%; p = 0.0001].


The older is related to the rate of admission to a ward and

mortality. The length of stay takes longer when is with high severity.


Test of MNA-SF in an acute geriatric department

R.A. Scheller


, K. Weil


, E. Holm




Odense University Hospital,



Krankenhaus St. Franziskus-Hospital, Flensburg,


Nykøbing Falster



Nutrition of geriatric in-patients requires special atten-

tion in order to secure a sufficient intake. With the present study, we

want to investigate the capability of the Mini Nutritional Assessment

(MNA) to identify patients, who do not need nutrition support.


Patients acutely admitted to a geriatric unit were given

maximal oral nutrient support. On admission patients were screened

using MNA and trained nurses registered the total intake of calories

and protein. 67/80 patients got 3 registrations or more. Each patient

had at least one registration. Patients with significant impaired cogni-

tive status were excluded.


In total 200 patients were included with 18 samples during 3

months. 80 patients participated after mental screening. Mean Barthel

index on admission was 43 ± 29,5, mean age was 82.6 ± 6,9. According

to MNA score, 73 patients (91%) were malnourished (MNA score 0


or in risk of malnutrition (MNA score 8

11), and 7 (9%) were in normal

nutritional status. All patients with MNA > 11 got more than 75% of

their energy need as recommended in Denmark.

Key conclusions:

A massive majority of acutely admitted geriatric

patients are in risk of malnutrition. Maximal nutrient support should

therefore be given as soon as patients are admitted. Initial direct

registration of calorie and protein intake can be used to guide further

nutrient support. Only 7/80 patients had an MNA > 11. Nutritional

screening with the MNA is therefore not useful in this patientgroup.


Utility of urine dipstick testing among elderly patients admitted to

the emergency department

S. Sintra, A. Matos, C. Filipe, P. Dias, I. Fonseca, A. Simão, M. Veríssimo,

A. Carvalho.

Centro Hospitalar e Universitário de Coimbra, Coimbra,



The urine dipstick test (UDT) is a frequently ordered

rapid screening test to exclude the presence of a urinary tract infection

(UTI). This study aimed to evaluate indications and results of UDT in

acute care.


Cross-sectional study of a convenience sample of emer-

gency department elderly patients who had UDT performed between

April 11 and April 17, 2016.


Of 1,342 patients, 154 underwent UDT on admission (median

age, 80 years; 50.6% women; 13.6% with urinary catheter). There were

specific symptoms or signs of UTI in 41 cases (26.6%), nonspecific

symptoms or signs in 25 cases (16.2%) and no symptoms or signs of UTI

in 88 cases (57.1%). UDT results were positive in 68 cases (44.1%). 55

patients underwent urine culture (of which 30.9% were positive). The

sensitivity of urine dipstick as a proxy for culture was 82.3%, with a

specificity of 56.4%. The sensitivity and specificity of UDTas a proxy for

urine culture by specific symptoms was 100% and 54.5% respectively.

Of 92 patients receiving antibiotics, 54 cases (58.7%) were for a non UTI

indication while 38 (41.3%) received antibiotics with no explanation

other than suspected UTI. Positive UDT results were associated with

increased probability of antibiotic prescription (p < .001) among

asymptomatic patients.


As seen in the present data, most patients lacked an

appropriate clinical indication for UDT. The accuracy of UDT as an

indicator of a positive urine culture or specific symptoms of UTI is poor,

contributing to overdiagnosis and excessive use of antibiotics for UTI.


Acute hospital admissions in nursing home residents: a trigger to

think ahead!

J. Soh, J. O

Keeffe, D. O

Shea, G. Hughes.

St Vincent

s University Hospital,

Dublin, Ireland


Nursing Home Residents(NHRs) have complex health-

care needs due to advanced age, multiple comorbidities and high

levels of dependency. Acute hospital admissions of older people

are associated with risks and complications. Despite this, transfer of

NHRs to hospitals remains common. This study aims to examine the

relationship between acute hospital admissions and survival benefits

among NHRs.


Retrospective analysis of NHRs with unscheduled admis-

sions to a tertiary hospital over a 2 year period, from 2014 to 2015.


There were a total of 1219 unscheduled admissions from 929

residents. This represented 4.8% of 25,336 unscheduled admissions

in the time period.62% were women and mean age was 85 years. Of all

admissions, 36% were recurrent admissions. 293 residents had more

than 1 admission.

The overall 6 month mortality of NHRs after hospital admissions was

34%. 18%(n = 167) died during their hospital stay, with 81% of deaths

occurred within the first 15 days. Following hospital discharge, a

further 16%(n = 124) died in nursing homes within 6 months. 40% of

this cohort died within 1 month of hospital discharge.

NHRs with more than 1 admission had poorer outcomes. Their overall

6 month mortality was significantly higher at 37.5% vs 28.5% in

residents with single admission (p = 0.006). In-hospital mortality

among re-attenders was 20.5%, compared to 16.8% in those with 1

admission (p = 0.17). Following hospital discharge, NHRs with more

than 1 admission had significantly higher 6 month mortality in their

nursing homes, compared to those with single admission (21% vs 13%,

p = 0.009).


Acute hospital admissions are associated with poor

survival outcomes among NHRs. Hospital admissions, in particular

recurrent admissions, should prompt early discussions regarding

appropriate end of life care.


Functional focused care: content validity of function focused care

behavior checklist

J. Tavares


, J. Grácio


, L. Nunes




Coimbra University Hospital Centre



The prevention of functional decline (FD) should be

considered a priority in the care of hospitalized older adults (OA).

A functional focused care (FFC) philosophy promotes independence

and physical activity during hospitalization. Nurses have a central role

in the implementation of FFC. This study aims to: (1) translate, adapt

and validate the FFC Behavior Checklist (FFCBC) for the Portuguese

population; and (2) evaluate content validity index (CVI) using an

expert panel.


Principles of good practice for translation and cultural

adaptation were used. The analysis of content validity included CVI,

probability of a chance occurrence (pc) and modified Kappa (MK).

Seven experts (geriatric clinicians and researchers) evaluated the tool.

SPSS software, version 20, was used for the statistical analysis.


A preliminary version of FFCBC was obtained. This version

was revised in three rounds, the suggestions of experts were

incorporated into each review until all items reached a CVI

0.8. In

the final version, there were 13 items with a CVI = 1 and 6 items with a

CVI = 0.856. The average value of the IVC was 0.96 and the universal

Poster presentations / European Geriatric Medicine 7S1 (2016) S29