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

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(24%) had Arterial Hypertension, 17 (8.5%) alterations of the Lipid
Metabolism,13 (6.5%) had Chronic Kidney disease,18 (9%) had anemia,
28 (14%) Atrial Fibrillation and 13 (6.5%) had history of cancer. The
relation between these comorbidities and its comparison with the
younger population was also established.
Conclusions: The geriatric population is a pluripathological one, with
many comorbidities influencing both life expectancy and quality of
life. It is important to be aware of the main comorbidities present in
this increasingly growing population, in order to adopt adequate
diagnose and treatment attitudes.
P-214
Anemia in an inpatient geriatric population
J.O. Ribeiro 1, J.P. Machado1, S.C. Martins1, A.A. Nunes1, J. Marques1,
E. Oliveira 1, J. Alexandre1, A. Monteiro1. 1Centro Hospitalar
Tondela-Viseu, Viseu, Portugal
Introduction: With the ageing of population, a great percentage of the
patients observed on the daily practice of Internal Medicine are elder.
This specific population is associated to a significant number of
comorbidities. This work results from the challenge to characterize the
geriatric inpatient population of one Internal Medicine ward.
Methods: In order to characterize the population, the clinical
codification sheets of all patients assigned to one team of Internal
Medicine specialists during the year of 2015 were requested, the
patients aged 85 years old or over were selected, and the data was
evaluated. On this particular work, a focus was taken on the patients
with the diagnosis of anemia.
Results: Of a total of 448 patients, 160 (35.7%) are aged 85 or older.
Of these, 43 (26.9%) are aged 90 or older. From the 160 patients aged 85
or older, 34 (21,3%) had the diagnose of Anemia. This comprises 38.6%
of the patients with anemia, with 54 patients aged below 85 (18.7%)
having the same diagnose. The gender distribution was 41.2% (14)
males and 58.8% (20) females. Of the 34 anemias, 11 (32.4%) were
classified as Chronic Disease Anemia, 8 (23.5%) Iron Deficiency
Anemia, 4 (11.8%) Chronic Kidney Disease Anemia, and 2 (5.9%)
Neoplasic Anemia. The relation with other comorbidities was also
studied.
Conclusions: Anemia has an elevated prevalence in the geriatric
population, influencing significantly the patients’ quality of life and
altering the natural history of many other comorbid states and
pathologies concomitantly present in the elder population.
P-215
Pancytopenia in the elderly: disease or comorbidity?
A. Roque 1, J.G. Frade2, A. Simão 3, F. Rodrigues2, A. Carvalho 3. 1Clinical
Hematology Department, Centro Hospitalar e Universitário de Coimbra,
2Clinical Pathology Department, Centro Hospitalar e Universitário de
Coimbra, 3Internal Medicine Department, Centro Hospitalar e
Universitário de Coimbra, Coimbra, Portugal
Objectives: Pancytopenia is defined as the co-existence of hemoglobin
<13 g/dL (male) or <12 g/dL (female), leucocytes <4/μL and platelets
<150/μL. Although studies about this condition in elderly population
are rare, its knowledge is important in order to develop a correct
approach.
Methods: We retrospectively analyzed all elderly patients (age ≥ 65
years old) hospitalized in the Internal Medicine Ward of a tertiary care
hospital between January/2013 and December/2014.
Results: During this period, a total of 8649 patients were selected;
2.9% of the elderly patients presented pancytopenia at least in one
evaluation during the hospitalization (n = 250; 46.4% ≥80 years,
median age = 79 years; 59% male). Main admission causes were
respiratory (29.6%) and urinary tract infections (12.8%) and cirrhosis
(8.8%), with pancytopenia representing only 4.8%. Main comorbidities
were hypertension (57.2%), chronic kidney disease (47.6%) and heart
failure (40.4%). At admission, 48% of patients already presented
pancytopenia and 47.4% had a Katz score ≥4. The main probable
cause for pancytopenia were infection (28%), hematological disease
(18.4%), liver disease (13.2%) and drugs (13.2%). The length of hospital
stay was significantly higher in patients with pancytopenia (14.5 ± 21.5
vs 9.6 ± 9.6 days, p = 0.001), and 29.6% of patients still had pancyto-
penia at discharge. Pancytopenic patients had a higher but not
statistically significant risk of in-hospital mortality (18.4% vs 17.2%,
p = 0.61), with a median survival-time after diagnosis of 11.8 months.
Conclusion: In our cohort, pancytopenia was associated with increas-
ing morbi-mortality in elderly hospitalized patients. Pancytopenia
is a relatively frequent but possibly undervalued condition,
mainly motivated by non-curable pathologies, that merits careful
consideration.
P-216
MDT hub aims to improve the health and well-being of frail and
elderly patients with complex needs and are high risk of hospital
attendance and deterioration in health
S. Saber, B. Mohanlal, J. Woodward, S. Chatterjee, I. Macalino,
M. Romain, D. Lee. Royal Free Hospital
Objectives: Multidisciplinary (MDT) Hub aims to improve the health
and well-being of frail and elderly patients with complex needs and
are high risk of hospital attendance and deterioration in health.
This service is available for Camden & Barnet residents (Boroughs in
London UK). Criteria for referral is frail patients with frequent GP or
hospital attendance, complex social needs and not engaging with
health professionals in community.
Services offered are specialist input, physiotherapy, clinical psych-
ology, mental health, palliative care, easy access to referrals with
specialist and integrated care plan for individual patients.
Methods: Retrospective study of 6 months pre and post Hub period
carried out to confirm complex care need was addressed.
Results: 128 patients was audited. Median age was 81 ± 2.
The main source of referral was from secondary care specialist 74%
(n = 94).
Reason for referral was clinical frailty, noncompliance with medica-
tion, recurrent falls with injury, poor control diabetes, COPD exacer-
bations, heart failure and alcohol related complications, self-neglect
and social isolation.
Post Hub impact of MDT shows reduction in emergency department
attendance 2 times compare to 5 times in pre Hub, number of hospital
admission were 2 times in contrast 4 times in pre Hub. The cost of
these admissions has come down and emergency Bed days have
decreased so patients are spending more time at home.
Length of hospital stay reduced to 16 days compare to 31 days in pre
Hub group.
Majority of the Hub patients discharged their own home 77%(n = 99)
with increased care support.
One year mortality was 21%(n = 28).
Conclusion: Significant reduction of hospital admission, complex care
need, advanced care plan was addressed by Hub.
P-217
Lack of association among the different versions of Charlson
Comorbidity Index and the outcomes in 659 patients with acute hip
fracture
T. Salgado1, U. Miranda1, T. Alarcón1,2,3, J.I. González-Montalvo1,2,3,
J. Diez-Sebastían2,4, P. Gotor1,2,3 , I. Martin-Maestre1. 1Geriatrics
Departrment, Hospital Universitario La Paz, 2IdiPAZ, 3RETICEF,
4Biostatistics Department, Hospital Universitario La Paz, Madrid, Spain
Introduction: The Charlson’ s Comorbidity Index (CCI) was developed
to quantify the influence of comorbidities on survival. The Age-related
CCI (Age-CCI) was adapted to the age of the patient as an additional
risk factor and the Adapted Charlson’s Comorbidity Index (CCI-
Adapted) for predicting total yearly costs. We established a combin-
ation on both Age-related and Adapted Charlson’ s Comorbidity Index
(Age-Adapted CCI). The aim of this study was to determine the
association among the four indexes and the length of hospital stay,
the number of active medical conditions during hospitalization, the
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S85