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functional status at discharge and hospital mortality rate in patients

undergoing hip fracture.


A cross-sectional study was performed, applying the four


s indexes in 659 consecutive patients over 64 years admitted

with a fragility hip fracture from March 1st 2009 to November 30th

2012. Pearson

s correlation coefficient and comparison of medians

were used.


Mean age of patients was 85.03 (±7.03) years and 82.1% were

women. Acute average stay was 10.7 (±4.4) days and hospital mortality

was 2.7%. The association of Charlson

s indexes showed good Pearson


correlations among them, but weak correlations with length hospital

stay (0.186 to 0.219, p < 0.001) and with number of active medical

problems (0.400 to 0.517, p < 0.001). There were not statistical

differences among the scores in the different comorbidity indexes in

patients with good/poor functional status and hospital survival/



The four Charlson

s indexes did not provide additional

information in discriminating variations in the clinical parameters

analyzed in acute patients with hip fracture.


Overtreatment of type 2 diabetes in older people living in care

homes in the United Kingdom

N. Samarasekara, E. Dinsdale, A. Jain, M. Tang, S. Ninan.

Leeds Teaching

Hospitals Trust, United Kingdom


In the United Kingdom, fifty percent of older people

entering care homes die within fifteen months. For older people

with multiple co-morbidities and a short life expectancy, intensive

treatment of type 2 diabetes does not improve outcomes and may

cause harm with increased risk of mortality and hypoglycaemia.

National guidance recommends that HbA1c targets may be relaxed on

an individual basis for frail older patients but does not provide advice

on how to do so. American Diabetes Association (ADA) guidelines

provide a framework for HbA1c targets in older patients, depending on

frailty and co-morbidities.


We reviewed the patient records of patients over 80

years old discharged after July 2015 and recorded co-morbidities,

most recent HbA1c level and current diabetes treatment. Based on

ADA guidelines, we used a definition of overtreatment as


<53 and on a hypoglycaemic


HbA1c 53

63 and either (i) three

or more co-morbidities OR (ii) dementia/falls/end of life and on




In total 113 cases were reviewed. Based on ADA guidance, 38%

of patients were being over-treated for type 2 diabetes.

Key conclusions

A significant proportion of frail older people with

type 2 diabetes admitted from care homes in Leeds were over-treated,

increasing the risk of adverse events. Addressing this could lead to

benefits in terms of patient safety and hospital admissions.


A comparative study of bone health in Parkinson

s and non-


s patients presenting with fracture neck of femur

P. Shukla


, J. Hawkins




William Harvey Hospital,


William Harvey

Hospital, Ashford, UK


Patients with Parkinson

s disease (PD) have a sig-

nificantly increased risk of fracture, mainly of the hip. Many

studies have demonstrated that the bone mineral density (BMD) in

patients with Parkinson

s disease is lower compared with a non-


s disease (non-PD) patients. The causes for lower BMD in

PD are multifactorial. Some of these are modifiable either by physi-

cal exercise, dietary medication or pharmacological interventions.

Patients with PD do not get screened routinely for osteoporosis. Hence

they remain at increased risk of fracture, resulting in increased

morbidity and mortality.

The objective of this project was to study both groups (PD and non PD)

who presented with fracture neck of femur (NOF) and to identify

strategies to improve bone health in this group of patients.


We conducted a retrospective comparative study of

fracture NOF in PD and non-PD patients who presented between

May 2013 and May 2015. 25 patients were randomly selected for both


We reviewed their records for previous falls, fractures and bone

health assessment. We also reviewed their old medical records to

check whether they had had any previous osteoporotic fracture or not.

If they had had any previous fractures, we looked at the adequacy of

assessment and treatment.

The results:

In an age matched analysis of the data between PD and

non-PD group, we demonstrated that 46% of PD patients had a

previous history of falls compared to 27% in non-PD. Of these, 82% in

PD and 64% in non-PD patients were mobilewith a Zimmer frame prior

to fracture NOF.

As expected, a significant proportion of PD patients were found to be

at increased risk of falls due to postural instability (54%) and postural

hypotension (36%) compared to non-PD (16% and 0% respectively).

Only 9% of patients with PD who had had previous falls had received

adequate bone health assessment compared to the non-PD group


About 55% of PD patients had a previous osteoporotic fracture. Of

these 88% had osteoporosis and only 43% had received adequate bone

protection. Overall, 65% of PD and 16% of non-PD patients had

previously had an osteoporotic fracture.

64% of patients from each group were discharged to their primary

residence and 30% were sent for a period of rehabilitation.


This study highlighted that patients with PD have a

higher risk of falls as well as osteoporosis. Combined together, this

poses a significant risk of fracture NOF. It was not clear from the study

why these patients were inadequately assessed and treated.

I propose that the patients with PD who are at risk of falls should have

an assessment with dual-energy x-ray absorptiometry (Dexa). And if

Dexa scan is suggestive of osteoporosis they should receive adequate

bone protection.


Characterization of elder in an infirmary

N. Silveira


, L. Pedro


, E. Campôa


, F. Azevedo


, R. Pinho



V. Machado


, L. Cabezuelo


, M. Grade


, D. Faria


, L. Arez




Department of Medicine 4, Algarve Hospital Center


Hospital Unit, Portimão, Portugal


World population ageing is becoming more and more

a global theme in discussion. The characterization and comprehen-

sion of elderly and their specifications will allow to create stra-

tegies adapted to the geriatric population with more quality of life.

This study aims to characterize an elder population that needed



We selected all patients admitted in our Department of

Medicine between 2010 and 2015. Data was obtained through an

Institutional record named Assistential Quality Nucleus Studies

(NESQA). Statistical analysis was calculated with SPSS 23.


Of the total sample of 15,441 admitted patients we verified

12,129 were aged equal or higher than 65 years (mean 80.9 and

standard deviation 7.8 years), from which 50.6% were male. The vast

majority of admissions was from the emergency room (82.6%) and

presented with important Charlson Comorbidity Index (median score

of 5, 21.8% presented with a score of 4). Death rate in this subgroup was

of 16.5%.


Our elder population has a high mortality rate estimated

by Charlson Comorbidity Index (85% for a score higher than 5 points,

52% for a score of 4). These studies applied to the older population are

important in order to create better long term care units specialized in

geriatrics allowing this population to keep an active role in society

with quality of life.

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