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To identify CCD of patients

65 years admitted to an acute

medical ward of a general hospital.


A cross-sectional study during one day. Multimorbidity

was defined as co-existence of two or more chronic conditions,

and diagnosed based on the results of history taking, physical

examination, and medical records, if available. We included Katz

scale for functionality. The elderly is aged 65 years, and oldest old is

greater than or equal to 85 years. There was the dichotomy of the

variables to be compared using the Fisher exact test for the value of

p < 0.05 and determination of the relative risk.


126 patients had admitted, and 82.5% (104/126) were

identified as elders, 54% of the patients were females, the median

age was 78 and interquartile range 68.0

84.2 years. Concerning to

multimorbidity were identified 88.1% [n = 111] and to CCD 50%. When

stratifying the Katz index found without changing the functionality in

32.7%, moderate change 33.7% and serious deterioration 33.7%. We

note that CCD is associated with elderly [RR = 1.31; CI 1.10 to 1.55] and

almost duplicate with oldest old [RR = 2.10; CI 1.07 to 4.092].


In this reporting period we find that in general medical

wards, the inpatient profile is the elderly and oldest old associated

with a complex chronic disease.


Geriatric intermediate care and transitional care for frailty-related


K. Loeffler.

Geriatric Health Care Centers Graz, Graz, Austria


As a result of demographic change and increasing life

expectancy challenges in providing health care for our eldest are

predicted. Due to these changes hospitals and geriatric care facilities

have to face patients with complicated clinical disorders as well as

unstable, multi-morbid elderly patients with cognitive restrictions.

Geriatric patients require a longer period of convalescence, which

demands the development of special care facilities between hospital

and long-term care. This study addresses the improvement of geriatric

care for unstable, multi-morbid elderly patients with cognitive

restrictions discussing the establishment of a

Geriatric Intermediate

Care Unit



Literature research was conducted to extract criteria

describing the target group. Existing geriatric care facilities were

examined, if they could meet the needs of these patients. Moreover,

currently existing intermediate care units were reviewed. Afterwards

eleven experts in the field of geriatric care within German-speaking

countries were interviewed about the clientele, the performance

content, entry and exit criteria and existing limitations in



The results of this study show that geriatric patients are

treated best within an integrate care system including a


Intermediate Care Unit

in which patients are given a longer period of

convalescence and are scanned and transferred to the suitable long

term care facility, rehabilitation or home care.


For the purpose of developing such units further

research is needed not only in defining the clientele but also

concerning accurate demand. Furthermore the term


Intermediate Care Unit

has to be discussed in the German-speaking

countries to find a standardized definition.


Evaluation of a new structured tool to revise the elderly


prescriptions: DICTIAS-OBCv

F. Maronnat


, J. Belmin


, W. Jarzebowski




CHU Charles Foix, Ivry sur

Seine, France


Managing inappropriate prescriptions (IP) is a daily

problem in geriatrics. Within a population of hospitalized patients

under several medications we tried to evaluate a new tool to improve

medical prescriptions: DICTIAS-OBCv.


Observational retrospective study carried out on patients

admitted between June and October, 2014 in a geriatric ward.

Prescriptions at registration were revised using DICTIAS-OBCv.

Original prescriptions at registration and prescriptions revised

by DICTIAS-OBCv were both analyzed with START/STOPP tools

by spotting missing START prescriptions (MS) and prescriptions

matching STOPP criteria (S). The main criterion of judgement

was the evolution of the number of patients presenting at least one

IP (MS and/or S) after DICTIAS-OBCv, assessed by Mac Nemar Test. The

secondary criteria of judgement were the evolutions of the number of

global prescriptions and the number of patients presenting MS and S



62 patients, aged 83.9 years on average, were included. After

revision by DICTIAS-OBCv, the number of patients with at least one IP

decreased from 53 to 13 patients (RR = 0.25; p < 0.001). Therewere 421

prescriptions at registration (mean = 6.8/patient) then 338 (mean =

5.5/patient) after revision by DICTIAS-OBCv (p < 0.001). The evolu-

tion of the number of patients with MS and S was the following one:

MS 41 to 7 patients (RR = 0.17; p < 0.001); S 41 to 7 patients (RR = 0.17;

p < 0.001).


DICTIAS-OBCv is efficient to improve medical prescrip-

tions in both qualitative and quantitative terms.


Pressure ulcers


S.C. Martins, J. Olivério, A. Nunes, J. Machado, J. Marques, L.C. Matos,

A. Monteiro.

Internal Medicine Department, Centro Hospitalar


Pressure ulcers are among the most common conditions encountered

in acutely hospitalized patients or those requiring long-term institu-

tional care, most frequently in the elderly population, associated

with a negative impact in the quality of life. There are various risk

factors identified. The most important include immobility, malnutri-

tion, reduced perfusion, and sensory loss. This work aims to describe

the geriatric inpatient population followed by the authors, during

the year of 2015, with respect to the presence of pressure ulcers

and its characteristics. In order to characterize the population, the

clinical codification sheets of all patients assigned to one Internal

Medicine specialist were requested. All patients with at least 85

years old were included. During that year there were 253 inpatient

episodes with a total of 245 patients. For statistical purposes we

considered all inpatient episodes as distinct cases. Of 253 cases, 36%

(n = 91) were no less than 85 years old. Of these 36.3% (n = 33) were

aged 90 or older. 8.8% (n = 8) had pressure ulcers with one patient

having 2 in different localizations. The majority were classified as

grade IV (n = 3) and one as grade III. There were none as grade I or II.

As we can see there were 4 cases with no reference to grade. With

regard to localization 4 were on heel, 2 on the hip and 1 on the

lower back. In 2 patients no classification was made. 50% of the cases

were bedridden, 25% had dementia and 37.5% had diabetes. A total of

3 patients lived in nursing home. The presence of pressure ulcers

constitutes a geriatric syndrome consisting of multifactorial patho-

logical conditions. The latest Portuguese epidemiological data are

related to hospital care, where the average prevalence of pres-

sure ulcers is about 11.5%. This work aims to sensitize physicians to

this condition as pressure ulcers are a public health problem and an

indicator of quality of care which prolongs hospitalization and

increases readmissions.


Risk model to predict mortality in older patients with heart failure

L.F. Arana


, J.M. Abarca


, E.L. Alonso


, F.J.M. Sánchez


, P.G. Gregorio




Geriatric Medicine Department at Clínico San Carlos Hospital, Madrid,



The aim of this study is to develop a risk model to predict

six-month mortality in older patients admitted with acute heart

failure (AHF) in a Geriatric Department.


Observational cohort study that includes all patients

admitted to a Geriatric Acute Care Unit with AHF between January,

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