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

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admitted from January 2013 until December 2015 in an internal
medicine ward.
Methods: We analyzed gender, age, main diagnosis, Charlson
Comorbidity Index (CCI), previous admissions in other hospital
wards or emergency room in the 3 months before admission, the
day and time of death. Sigmaplot 12.5 software was used for statistical
analysis.
Results: Study population counted with 458 inpatients, 54% female
and mean age of 77,8 ± 14,27 years. Top three primary diagnosis were
pneumonia (47,5%), cancer (12,1%) and stroke (11,1%). Mean hospital
admission length was 15,4 ± 14,33 days and mortality rate 21,6%. CCI
score differences between deceased and discharged patients were
even larger when age-adjusted (CCI = 4 ± 2,1 vs 2,6 ± 2,9). Men had
higher CCI score and mortality rate than women (3,2 ± 2,6 vs 2,6 ± 2,1
and 26,9% vs 17,1%). Time and week day of death, as well as previous
admissions, show no disparity in mortality rate.
Conclusion: This study validates CCI, especially when age-adjusted. It
was, also possible to notice the high mean age in the Internal Medicine
ward which entails higher CCI scores especially in male patients.
P-207
The use of dose-dense weekly paclitaxel (WP) chemotherapy in
elderly patients with gynaecological cancers
A.S. Pericao, F. El-Khouly, M. McCormack, R.S. Kristeleit,
J.A. Ledermann, R.E. Miller. University College London Hospital
Foundation Trust
Introduction: Gynaecological cancers are the 4th leading cause of
cancer deaths in females, with over 5000 cases diagnosed in those ≥65
years annually in the UK. WP chemotherapy is often used for the
treatment of advanced disease. Concerns over toxicity and comorbid-
ities may limit the use in the elderly. We sought to examine the
tolerance and outcome of elderly patients (pts) treated with dose-
dense WP for gynaecological malignancies over a five-year period.
Methods: Clinical records of pts, ≥65, treated with WP over a 5-year
period were reviewed. Details regarding chemotherapy toxicity,
treatment duration, response to chemotherapy and co-morbidities
were recorded.
Results: 79 women ≥65 years (median 72, range 65–86) treated with
WP (80 mg/m 2 days 1,8,15 q21 days) were identified. 73, (89%) and 6
(11%) received WP for ovarian and endometrial cancer respectively.
Median number of cycles received was 4 (range 1 –6) with 72% of
patients receiving full dose. 23 pts (29%) required a dose reduction
(DR), 7 pts (9%) were DR from cycle 1 due to concerns over age or
poor ECOG PS. The remainder underwent subsequent DRs, commonly
for neuropathy (14%) and fatigue (3%). WP was discontinued due to
toxicity in 3 (3.8%) and medical co-morbidities in 1. 46% of pts had
at ≥1 significant co-morbidity, most commonly hypertension 30
(37.9%) and hypercholestorolaemia 11 (22.78%). Partial response,
stable disease and progressive disease were observed in 35.4%, 17.7%
and 43% of pts respectively.
Conclusions: WP was well tolerated in pts ≥65 years. Response rates
are comparable to that seen in the general gynaecological population.
P-208
Is Anaemia overlooked in Geriatric care?
K. Phyu 1, R. Asif1, A. Verma1, M. Hegde1. 1Department of Care of Elderly
Medicine, Royal Gwent Hospital (RGH), Newport, Wales, UK
Introduction: Anaemia is very common in the Elderly and prevalence
increases with advancing age. It is significantly associated with
increased mortality, poor quality of life and prolongs hospital stay
(1). Despite current specialist guidelines, anaemia in elderly may be
poorly managed.
Aim: To assess the prevalence of anaemia and actions taken on it in
Geriatric wards
Method: We prospectively studied patients with low Hb level at
admission in Geriatric wards from October 2015 to January 2016. We
defined anaemia as Hb < 11.5 for females, <13.5 for males (5). Analysis
included prevalence and type of anaemia and whether or not
management delivered according to national guidance (2).
Results: We analysed 86 cases of anaemia (52% female, 48%male) with
mean age 83 and mean Hb of 89 gm%. Majority had normocytic
anaemia (87%), 11% had Microcytic and 2% Macrocytic. All patients
had multimobidities (>4 clinical conditions) which included CKD
(25%) and Diabetes (19%). During diagnostic work up, only 40% had
haematinics and 14%coeliac screen checked. In Iron deficiency group,
only 33% had OGD. Similarly 76% had no colonoscopy done. Among
low B12, 11% had no replacement.
Discussion: There was high prevalence of anaemia, likely due to
chronic diseases. As anaemia is often an incidental finding in elderly, it
is overlooked. This may correlate to higher incidence of cognitive
impairment, frailty, falls, fractures, increased mortality (2–4), pro-
longed hospital stay and poor performance status. Anaemia manage-
ment is currently neglected in our practice possibly due to emphasis
on acute conditionmanagement. We recommend that anaemia should
be highlighted in the problem list and managed effectively.
References
1. Culleton BF, Manns BJ, Zhang J, Tonelli M, Klarenbach S,
Hemmelgarn BR. Impact of anaemia on hospitalization and
mortality in older adults. Blood. 2006;107(10):3841–6.
2. Goddard AF, McIntyre AS, Scott BB. Guidelines for the
management of Iron Deficiency Anaemia. Gut 2000;46(iv):1–5.
3. Beghe C, Wilson A, Ershler WB. Prevalence and outcomes of
anaemia in geriatrics: a systematic review of the literature. Am J
Med. 2004;116(Suppl 7A):3S– 10S.
4. Denny SD, Kuchibhatla MN, Cohen HJ. Impact of anaemia on
mortality, cognition, and function in community-dwelling elderly.
Am J Med. 2006;119(4):327–34.
5. Izaks GJ, Westendorp RG, Knook DL. The definition of anaemia in
older person. JAMA 1999;281:1714– 1717. doi:
P-209
When it rains, does it always pour? Patterns of comorbidities
among older Polish adults living in the community – the PolSenior
Study
K. Piotrowicz1, A. Pac2, A. Skalska1, A. Szybalska3, A. Parnicka1,
T. Grodzicki1. 1Department of Internal Medicine and Gerontology,
Jagiellonian University Medical College, 2Epidemiology and Preventive
Medicine, Jagiellonian University Medical College, Kraków, 3International
Institute of Molecular and Cell Biology, Warsaw, Poland
Objectives: Effective treatment of patients with multimorbidity is still
a challenge of current geriatric medicine. The aim of this study was to
examine the patterns of comorbid conditions in a representative group
of elderly people in Poland.
Methods: The presented study is a part of the PolSenior Study, a
nationwide, cross-sectional study of community-dwelling older adults
living in Poland. Based on medical questionnaires (including infor-
mation on the prevalence of 16 chronic diseases), we gathered
complete data for 3,964 participants aged 65 and older. The patterns
of multimorbity were identified with principal factor analysis models,
with Varimax rotation, based on polychoric corretation matrix.
Results: Five multimorbidity patterns were identified in all examined
subjects, with the models of decreasing coefficient of determination
(R2) values, respectively: cardiological [coronary-artery disease (CAD),
heart failure (HF), arrhythmias], cardio-metabolic (hypertension,
diabetes t2 and impaired fasting glycaemia, obesity), renal (chronic
kidney disease, anaemia), mental [depression, cognitive impairment
(CI), epilepsy and Parkinson Disease], and other (depression, thyroid
diseases, osteoporosis). In those aged 65–79 the following multi-
morbidity patterns were observed: cardiological, mental-cerebrovas-
cular (depression, CI, cerebrovascular diseases, epilepsy and Parkinson
Disease), cardio-metabolic, renal, and endocrino-metabolic (thyroid
diseases, osteoporosis). On the other hand, in those aged 80 plus
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S83