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life according to the performed treatment (strategy invasive (SI) vs

conservative (SC)). The QL was analyzed with the 5D EuroQol scale

and its value index EQ-5D-5L by telephone survey in a follow up to

24.8 ± 5.7 months. Multivariate statistical analysis with SPSS version

18 stadistics.


Expected more catheterization in that group Awas indicated

(82.2% low iCh vs 52.2% high Chi). Patients with conservative

management in Group A had older at admission (86.0 ± 5 SC vs

83.3 ± 4 SI; p = 0, 047) and increased renal dysfunction (CKD > 3 87.5%

SC vs. 62.2% SI; p = 0, 027) than those who performed coronary

angiography. In this group with low Chi, SI improved survival

significantly (p = 0.027) and also the QL (p = 0, 024). In Group B

(high Chi) decision to adopt an invasive attitude was related to higher

degree of independence (92.4% SI vs 49.2% SC; <0.001), fewer heart

failure (29.5% SI vs 40.8% SC; =0, 025) and improved renal function

income (56.8% CKD

3 SI vs 79% CKD

3 SC; p = 0, 002). However

in patients with high Chi there were no differences in survival to

adopt a SI or SC strategy. There are differences in this group in the QL

depending on the therapeutic management.


In our series, the Chi proved to be useful to select those

patients with low comorbidity that can benefit from an invasive

operation, improving both their survival and quality of life.


Thyroid function tests in elderly acutely ill inpatients

one year

retrospective study

R. Moreira da Cruz, A. Martins, M. Aveiro, M. Cruz, F. Sousa, F. Ribeiro,

G. Jesus.

Baixo Vouga Hospital Center, Aveiro, Portugal


The elderly are considered high risk population for

thyroid dysfunction. Thyroid function tests should not be routinely

undertaken unless the patient is considered high risk. In the acutely ill

patients thyroid functions tests are known to be altered and should not

be routinely performed.

Material and methods:

Retrospective study with review of data of

elderly patients admitted in the Internal Medicine ward in 2015, with

the diagnosis of thyroid dysfunction. The goal was characterize the

thyroid dysfunction in the elderly and understand why thyroid tests

were performed.


The study had 153 patients (67.3% feminine). 30 patients had

Hyperthyroidism and 132 hypothyroidism. Both groups had a median

age of 81 years. The diagnosis was unknown in 28.1% of patients. In the

hyperthiroidism group the most frequent motives to suspect dysfunc-

tion were known thyroid pathology (76.7%), heart failure (35.3%),

tachyarrhythmia (36%), medications (26.7%). In the hypothyroidism

group most prevalent motives were known thyroid pathology (57%),

heart failure (49.5%), dyslipidemia (42.2%), medications (21.9%),

oedema (21.1%), hyponatremia (17,4%), obesity (19.5%), rabdomyolisis

(11.4%), bradyarrithmia (13.8%). Mortality in the patients was 11.8%.

(6.7% of the patients in the Hyperthyroidism group and 13% in the

Hypothyroidism group).


There are no defined criteria onwhen to ask thyroid tests

in inpatients, although is well known that these can be affected in acute

illness and so they should only be evaluated only when dysfunction is

suspected. In our study the main reason for this evaluation was prior

thyroid pathology, heart failure, dyslipidemia and medications.


Indication and outcome of tilt table testing in older adults

N. Nordin


, D. Tiwari


, M. Vassallo




Geriatric Unit, Medical

Department, Hospital Sungai Buloh, Malaysia;


Medicine for Elderly

Department (MFE), Royal Bournemouth and Christchurch Hospital,

United Kingdom


Head up tilt (HUT) table testing is awidely accepted tool

in the clinical evaluation of patients with syncope. It is also useful in

assessing older patients with recurrent unexplained falls.


Retrospective review of case notes, the indications,

appropriateness, outcomes and safety of HUT test, as well as evaluated

outcomes in patients

80 years compared to <80 years old. Cases were

analyzed using SPSS version 20.


93 patients were recruited over 2 years. The mean age was 72

years, [40 (43%)

80 years]. The majority of referrals came from

geriatric medicine. Light headedness was the commonest indication

for HUT in those

80 years (p < 0.014; OR: 0.35(0.125


Unexplained falls were also higher in this group,16/24 vs 7/46

[p < 0.003; OR 0.228(0.083

0.631)]. Blackouts/collapses were com-

moner in those <80 years [33/53(62.3%) vs 12/23(42.4%) p < 0.058; OR:


5.16)]. There was a significantly higher number of vasovagal

syncope confirmed by HUT in the <80 group, [29/31(93.5%) vs 13/19

(68.4%) p < 0.019; OR: 6.69(1.188

37.7)]. Only 2 cases were diagnosed

with postural orthostatic tachycardia syndrome (POTS). 7/12 (58.3%)

of those age

80 with unexplained falls showed a positive HUT test

[P < 0.007, OR: 0.118(0.021

0.653)]. There was no association between

medications and outcomes. 91(97.8%) had no complications during

the test. Seizure (2/93) was the commonest complication during the



In patients

80 years, unexplained falls is a strong

predictor for a positive Tilt Test. This finding adds to other studies

identifying unexplained syncope as an indication for the test. HUT is a

relatively safe procedure, and it should be reserved for relevant cases.


Prevalence of adrenal insufficiency in elderly medical admissions

in Hospital Sungai Buloh

I. Adam


, S. Shanmugam


, N. Nordin




Department of Medicine,

Hospital Sungai Buloh,


Geriatric Unit, Department of Medicine, Hospital

Sungai Buloh, Malaysia


Adrenal insufficiency (AI) is a life threatening disorder.

Primary AI is uncommon in elderly person. Most cases results from

rapid withdrawal if glucocorticoids from chronic administration,

hence the term tertiary AI.


To study the prevalence and factors associated with

adrenal insufficiency among medical admissions in Hospital Sungai



The characteristics of patients were retrospectively analyzed

via datasets from electronic medical records.


A total of 110 patients (63.6% male, 36.4% were aged 60 and

above) were recruited in the study. 25/46 (62.5%) of those aged >60

were diagnosed with Tertiary AI, p < 0.001 (OR: 0.275 (0.113


There were no associations between age and primary or secondary AI.

31/39 (77.5%) >60 years, whilst 55.6% below aged 60 had reported

fatigue as the main symptom; p < 0.022 OR; 0.365(0.152

0.880). There

were no significant associations reported with age for abdominal

pain, myalgia, loss of weight, and even dizziness. Also, there was no

association between signs of AI with age. Both Pneumonia (52.5%,

p < 0.003) and uncontrolled Diabetes (52.5%, p < 0.04) were the main

reason for admission among elderly diagnosed with AI. This was

followed by acute coronary syndrome, p < 0.002. Other associated

diseases were insignificant. Hyponatremia was related to Tertiary AI

(56% > 60, and 33.3% < 60, p < 0.05). 4/25 (16%) of the elderly with

Tertiary AI had eosinophilia, p < 0.010. Tertiary AI was also associated

with traditional medications (p < 0.000).


Tertiary AI is the commonest type of AI in elderly

population, and this was significantly associated with fatigue as

the presenting symptom. Traditional medication plays a role in the

prevalence of AI. The high morbidity rate validates the need to have a

high suspicion of index for diagnosis.


Mortality and comorbidity in an Internal Medicine ward

R. Osório, T. Salero, A. Florêncio, C. Mendonça, A. Lopes.

Medicina Interna 1, Unidade de Faro, Centro Hospitalar do Algarve,



This study has the objective of characterize mortality in an

Internal Medicine ward. We did a retrospective study of patients

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