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

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Methods: 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.
Results: 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 –3.7]).
Discussion: 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.
P-161
An ageing population – characterization of the hospitalized elderly
population in an Internal Medicine Department
A.R. Barbosa 1, O. Gonçalves1, V.P. Dias1. 1Centro Hospitalar de Vila Nova
de Gaia/Espinho, Vila Nova de Gaia, Portugal
Introdution: 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.
Methods: 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™.
Results: 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.
Discussion: 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%.
Conclusion: Population aging results in inpatients with a greater
number of comorbilities, more disability and longer hospitalizations.
P-162
Underuse of oral anticoagulants and inappropriate prescription of
antiplatelet therapy in older patients with atrial fibrillation
L. Averlant1, G. Ficheur2, L. Ferret2, S. Boulé3, F. Puisieux1, M. Luyckx4,5,
J. Soula 2, A. Georges2, R. Beuscart2, E. Chazard2, J-B. Beuscart1,2. 1CHU
Lille, Geriatrics Department, 2Univ. Lille, EA 2694, 3CHU Lille, Cardiology
Department, Lille, 4Pharmacy Department, Denain General Hospital,
Denain, 5Univ. Lille, EA GRITA, Lille, France
Introduction: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
P-163
Medical comorbidities in the oldest old: findings from the
Portuguese national hospitalization database
D. Brandão1,2,3, O. Ribeiro 2,3, A. Freitas1,2, C. Paúl2,3 . 1Faculty of
Medicine, University of Porto (FMUP), 2Center for Health Technology and
Services Research (CINTESIS), 3Research and Education Unit on Ageing
(UNIFAI- ICBAS/UP), Porto, Portugal
Introduction: 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.
Methods: 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.
Results: 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
(80–89 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.
P-164
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–S259 S71