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

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inventory (BDI) scale score and Charlson comorbidity index score; and
decrease in haemoglobin concentration, iron, transferrin and albumin
serum levels, and in mini mental state examination (MMSE) scale
score, were also found in frail patients. Using adjusted models,
we found that gender, MMSE score, BDI score, and iron, ferritin, and
albumin serum levels as independent variables associated with frailty.
Conclusion: Frailty is a high prevalent condition in ESRD patients
under dialysis, particularly in female patients, which is associated
with a decrease nutritional status and cognitive function and with
increased depressive symptoms.
P-168
Nosocomial infections in hospitalized elderly and their possible
relation
K. Dostalova, L. Kukuckova, S. Moricova, J. Luha. Department of
Preventive and Clinical Medicine, Faculty of Public Health, Slovak Medical
University, Bratislava, Slovakia
Introduction: Antibiotic therapy is the key factor which alters the
colonic flora in polymorbid repeatedly hospitalized elderly. These
patients are at high risk to obtain Clostridium difficile (CD) colitis.
Dehydration accompanying diarrhoea often requires monitoring the
fluid balance by insertion of a permanent urinary catheter.
Methods: We retrospectively analysed data of 258 patients hospita-
lized for 12 months at the Department of Long term ill in 2014.
Results: 58 patients developed diarrhoea, 20 men (34.5%) and 38
women (65.5%). The average age of patients with diarrhoea was 81
years (37 –97 years) in geriatric age were 87.93%. In 28 patients (10.2%)
positivity of both CD antigen and toxin in stool were diagnosed during
hospitalization, of them 7 men (25%) and 21 females (75%). We
determined the impact of risk factors on the presence of the CD toxin
in the stool specimen. Female sex is more at risk, bowel disease,
diabetes mellitus, cancer were not statistically significant linked to the
presence of CD toxin. 70.7% of the 58 patients with diarrhoea had
permanent urinary catheter (PUC), of which 39% developed urinary
infection. Up to 84.2% of all patients with urinary infections had
inserted PUC. 35 (85.4%) of the patients with PUC were in geriatric age.
Conclusion: All health care professionals should be in permanent
dialogue reviewed the current epidemiological situation and consider
antibiotic spectrum also with regard to the risk of CD colitis
development. This disease is sometimes tricky especially for frequent
recurrences despite the treatment.
P-169
Impact of oral health status and oral hygiene behaviours of older
patients admitted in a medical ward in survival and hospital
readmission at 6 and 12 months after discharge
M.J. Serpa 1, S. Duque2,3, Y. Mamade1, M. Maia 1, A.W. Soares1, C.B. Forte1,
Á. Chipepo 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: Oral health (OH) is usually underestimated in elderly
despite its impact in nutrition and general health. Previous studies
showed that poor OH is associated with higher mortality. Our aimwas
to evaluate the impact of OH and OH behaviours in outcome at 6 and
12 months (6 M, 12 M) of patients ≥75 years after discharge.
Methods: Prospective longitudinal cohort study of 100 patients.
Comprehensive geriatric assessment, dental examination and OH
questionnaire at baseline. Outcome assessed by phone contact and
hospital record analysis.
Results: Average age 83.7 years, 63% males, average Cumulative Illness
Rating Scale Geriatrics 11.2, average Barthel score 62.6, 70% malnour-
ished, 31% cognitively impaired. Average number of teeth (ANT)
6.7 ± 8.4. Prevalence of caries, periodontal disease and usage of oral
prosthesis (OP) 24%, 21% and 36%, respectively. Independence in oral
hygiene was inversely associated with mortality (6 M p 0.006, 12 M
p < 0.001). OP was also inversely associated with mortality (6 M
p 0.023, 12 M p 0.073 (trend)). These associations were also suppor-
ted by Kaplan-Meier survival curves. The presence of caries and
periodontal disease had no significant impact on survival. The ANT
was not associated with mortality, but Emergency Department
admission (EDadm) at 6 M and 12 M was associated to lower ANT
(trend). Usage of mouthwash was associated to lower EDadm during
the 2nd semester follow-up, but surprisingly toothpaste was asso-
ciated to higher EDadm. Predictors of readmission were not identified.
Conclusion: Impact of OH on outcome after discharge is not clear,
as showed by conflicting results. Remarkable, OP is related to higher
survival.
P-170
Association between comorbidity and geriatric syndromes and
survival in older patients admitted in an Internal Medicine ward
A.W. Soares1, S. Duque2,3, M.J. Serpa1, M. Maia1, Y. Mamade1,
Á. Chipepo1, S. Velho4, F. Araújo 1, 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: Comorbidity increase with ageing and may have an
important role in geriatric syndromes and mortality. Comorbidity
burden can be measured by several scores, although accuracy in the
elderly is limited. Cumulative Illness Rating Scale forGeriatrics (CIRS-G)
has been considered a comprehensive “gold standard” because it scores
presence and severity of disease. Our aim was to assess association
between CIRS-G and its 14 single items and health outcomes of a cohort
of 100 patients admitted to an Internal Medicine ward; association
with geriatric syndromes was also explored.
Methods: Prospective longitudinal study. Comprehensive geriatric
assessment at baseline, including nutritional, cognitive and functional
status. Survival and rehospitalisation at 6 and 12 months (6 M, 12 M)
assessed by phone contact and hospital record analysis.
Results: Average age 83.7 years, 63% males, average CIRS-G 11.2,
average Barthel score 62.6, 70% malnourished, 31% cognitively
impaired. No association was noted between CIRS-G and mortality,
emergency department admission and rehospitalization (6 M, 12 M).
Higher CIRS-G was noted in under/overweight (ns) and malnourished
patients (according Mini Nutritional Assessment) (p 0.009). Patients
with a lower Barthel score presented higher average CIRS-G (ns).
No association between CIRS-G and: other anthropometric and
laboratorial parameters and cognitive status. Association between:
CIRS-G heart score and over/underweight (p 0.032), CIRS-G neuro-
logical score and Barthel score decline at 12 M (p 0.027).
Conclusion: Comorbidity is related to geriatric syndromes such as
malnutrition (namely cardiac disease) and functional impairment
(namely neurological disease). Nevertheless, CIRS-G was not a
predictor of mortality and hospital readmission.
P-171
Functional outcome of older patients admitted in an Internal
Medicine ward at 12 months follow-up and relation to oral health
status and hygiene behaviors
M.J. Serpa1, S. Duque2,3, M. Maia 1, Y. Mamade1, A.W. Soares1, C.B. Forte1,
Á. Chipepo1, S. Velho4, F. Araújo 1, 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: Functional impairment and poor oral health (OH) are
common problems in elderly. Inability to maintain appropriate oral
hygiene can lead to poor OH; on the other hand, poor OH can result in
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S73