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Cohort study enrolling

90 years patients admitted to SCU

(January 2015

March 2016). We collected demographic and clinical

data, comprehensive geriatric assessment, discharge destination and

evolution within 30 days after discharge.


We included 287 patients (mean age ± SD = 92.9 + 2.64) years,

70.7% women, 33.7% institutionalized, with mean Barthel Index

(BI) = 48.7. Half had heart failure (54%), dementia (51.2%), dysphagia

(50.9%) or malnutrition (49.1%). The main diagnose at admission

was respiratory infection (48.4%), 47.7% presented delirium and at

discharge 73.8% returned to usual living situation, while 10.8% died.

Thirty days after discharge, 27.2% were dead. Dementia (p < 0.001),

cerebrovascular, disease (p = 0.037), pressure ulcers (p = 0.022),

dysphagia (p < 0.001), institutionalization (p = 0.007), malnutrition

(p < 0.001) and BI < 40 (p < 0.001) were associated with mortality. In a

logistic regression model, only malnutrition was independently

associated with global mortality (OR[95%CI] = 2.0[1.1



In our sample, nonagenarians were severe disabled, with

high prevalence of dementia, dysphagia andmalnutrition, one of every

4 died within admission and 30 days later. Malnutrition was the most

important risk factor for death. Our results encourage to explore risk

factors in such high-risk patients, which might be useful for eventual

advanced planning and decision making.


An ageing population

characterization of the hospitalized elderly

population in an Internal Medicine Department

A.R. Barbosa


, O. Gonçalves


, V.P. Dias




Centro Hospitalar de Vila Nova

de Gaia/Espinho, Vila Nova de Gaia, Portugal


In 30 years the number of old people in Portugal almost

doubled. Portugal is the second country from European Unionwith the

highest rates of severe disability among older people. The aim of this

project was to characterize the inpatient population with 75 or more

years old in an Internal Medicine Yard.


Consultation of medical records of hospitalized patients

with 75 or more years old in an Internal Medicine department from

January to March 2015. The Modified Ranking Scale (mRS) was used to

measure the disability grade. The data was processed using the IBM

SPSS Statistic



296 admissions with a mean age of 84,65 (± 5.7)

the oldest

patient was 101 years old. 55.4% were female. 107 patients scored 4 or

5 in the mRS. The most common reasons for patient admission was

Pneumonia (N = 95), Heart Failure (N = 67), Urinary tract infecion

(N = 26) and Isquemic stroke (N = 15). The prevalence of atrial

fibrillation was 46.1%. Hypertension was present in 81%, 53.1% had

Heart failure, Diabetes Mellitus was present in 39.1%, 29.8% of patiens

had cerebrovascular disease, the prevalence of isquemic coronary

disease was 10.8%. Chronic Kidney disease was present in 25.6%. The

death rate was 24.8%. The mean hospitalization time was 13,47 days.


It is notorious the great prevalence of some diseases as

hypertension, heart failure and atrial fibrillation in the elderly and the

high degree of disability present in 41%.


Population aging results in inpatients with a greater

number of comorbilities, more disability and longer hospitalizations.


Underuse of oral anticoagulants and inappropriate prescription of

antiplatelet therapy in older patients with atrial fibrillation

L. Averlant


, G. Ficheur


, L. Ferret


, S. Boulé


, F. Puisieux


, M. Luyckx



J. Soula


, A. Georges


, R. Beuscart


, E. Chazard


, J-B. Beuscart





Lille, Geriatrics Department,


Univ. Lille, EA 2694,


CHU Lille, Cardiology

Department, Lille,


Pharmacy Department, Denain General Hospital,



Univ. Lille, EA GRITA, Lille, France


Several studies have shown that the prescription of

antiplatelet therapy (APT) is associated with an increased risk of oral

anticoagulants (OACs) underuse in patients aged 75 and over with

atrial fibrillation (AF). An associated atheromatous disease may be the

underlying reason for antiplatelet therapy prescription. The objective

of the study was to determine whether the association between

underuse of OAC and APTs prescription in this population was

explained by the presence of an atheromatous disease.


We performed a retrospective, observational, single-centre

study between 2009 and 2013. Patients aged 75 and over with non-

valvular AF were identified in a database of 72,090 hospital stays.

Prescriptions of anti-thrombotic medications and their association

with the presence of atheromatous disease were evaluated by the

mean of a logistic regression.


2034 hospital stays were included. The mean age was

84.3 ± 5.2 years and the overall prevalence of atheromatous disease

was 25.9%. OAC underuse was observed in 58.5% of the stays. In

multivariable analysis, the prescription of an APT increased the risk of

OAC underuse (odds ratio [95% confidence interval] = 6.85 [5.50

8.58]), independently of the presence of a concomitant atheromatous

disease (odds ratio = 0.78 [0.60

1.01]). Among the 692 (34.0%) stays

with an APT monotherapy, only 232 (33.5%) displayed an atheroma-

tous disease.


The underuse of OACs is strongly associated with the

prescription of APTs in older patients with AF, regardless of the

presence or absence of atheromatous disease. Our results suggest that

APTs are often inappropriately prescribed instead of OACs.


Medical comorbidities in the oldest old: findings from the

Portuguese national hospitalization database

D. Brandão


, O. Ribeiro


, A. Freitas


, C. Paúl




Faculty of

Medicine, University of Porto (FMUP),


Center for Health Technology and

Services Research (CINTESIS),


Research and Education Unit on Ageing

(UNIFAI- ICBAS/UP), Porto, Portugal


The ageing of populations is expected to concur to a

growing proportion of elderly subjects with multiple medical

conditions. Age is an important risk factor for chronic diseases, and

previous studies found that the oldest old have more chronic

conditions when compared to younger older persons. The aim of

this study is to analyze comorbidities in hospitalizations by oldest old

persons in Portuguese public hospitals.


All inpatient episodes of hospital admissions by patients

aged 80 and older between 2000 and 2014 in Portugal mainland

(N = 1,837,613) were considered. Charlson index adapted to ICD-9-CM

codes was used to assess comorbidities. Exploratory descriptive

analyses of data regarding the frequency and type of comorbidities

were performed for the total sample and considering a distinction

between octogenarians, nonagenarians and centenarians subgroups.


The average number of Charlson comorbidities continuously

increased from 0.80 in 2000 to 1.73 in 2010 (116% more), and in 46% of

the episodes the individuals had no comorbidity. Congestive heart

failure and diabetes without chronic complications were the two most

frequent comorbidities (16.6%). An analysis by age group revealed that

these conditions remain the most prevalent in the younger subgroup


89 yrs), but among nonagenarians diabetes without chronic

complication was surpassed by cerebrovascular diseases. In the

oldest subgroup (100+), congestive heart failure was the most

common condition, followed by renal disease.

Key conclusions:

Findings from this study confirm the co-occurrence

of health conditions in the oldest old regardless of the considerable

percentage of hospitalizations without comorbidities found. Multi-

morbidity is associated with higher mortality and increased disability,

so it is an important public health problem that demands special

attention frommedical professionals who work with geriatric patients.


Impact of disease duration and cardiovascular dysautonomia on

hypertension in Parkinson

s disease

V. Brandi, D.L. Vetrano, M.S. Pisciotta, M.R. Lo Monaco, A. Laudisio,

G. Onder, R. Bernabei, G. Zuccalà.

Catholic University of the Sacred Heart,

Rome, Italy

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