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Profile of re-hospitalization in a private health provider that caters

exclusively geriatric patients in Brazil, in 2015

S.A.D. Silveira, Jr, E.F. Parrillo, A.L.A. Nascimento, D. Cabral.


Senior, Brasil


Evaluate the profile of readmissions in a particular health

care provider that caters exclusively geriatric patients (Prevent Senior)

in Brazil during the year 2015.


We conducted a prospective study between January 01 to

December 31, 2015, where evaluated all readmissions that occurred

during that period.


Were analyzed in 2,622 (8.01%) readmissions, of a total

population of 32.700 admissions. 45.53% of these re-admitted in up to

seven days post discharge; 44.41% readmitted for the same reason

discharge. 66% of readmissions were due to infectious aetiology,

12.9% from cardiovascular causes, 9% for palliative care, 6.6% for renal

insufiencia and 5.5% by other causes. The overall hospital mortality

was 9.28%, and the average length of stay was 4.42 days.


The results presented show a low rate of re-hospitaliza-

tion, low death rate and low time of permanency for the population

studied. The main reason for the readmission of this population were

the infectious causes, with pneumonia being the most responsible.

Such results show indirectly an efficient in-hospital management

mechanism of the different conditions that affected the population



HIV as potential risk factor for falls and risk factors for falls in

older treated HIV-infected

O.S. Smeekes, K. Kooij, F. Wit, P. Reiss, N. van der Velde.


Department of Geriatrics & the AIGHD


Recent studies have shown a high prevalence of falls in

the middle age HIV-infected. This study aimed to explore if HIV

positivity is associated with increased fall risk and to identify risk

factors for falls in older HIV-infected persons.


Data from the AGEhIV cohort was analyzed cross-sectionally

to assess the association between HIV positivity and fall history

(recurrent falls, any falls) and to assess potential fall risk factors within

the HIV positive group with multivariable logistic regression. Patients

were excluded if fall registration was missing. Variables included in

analyses were HIV characteristics, demographics and classical fall risk



In total, 535 HIV-infected and 522 HIV uninfected partici-

pants were included, with a median age of 52 (interquartile range

[IQR] 48

59 vs. 47

58). The HIV-infected fell recurrently in 11.6% of

cases vs. 8.9% of the HIV uninfected (P = 0.136). HIV was not sig-

nificantly associated with fall history. An independent interaction was

found between age and HIV for both outcome measures, suggesting

that HIV related falls occur at younger age (P = 0.073 vs. P = 0.025).

Significant independent factors associated with recurrent falls in the

HIV positive group were male gender OR 0.3, 95%CI (0.1

1.0), BMI OR

0.8, 95%CI (0.7

1.0), fear of falling, dizziness OR 0.9, 95%CI (1.2


and anti-depressants OR 3.2, 95%CI(1.1


Key conclusions:

In this large cohort study, fall prevalence in

HIV infected persons as well as fall risk factors are comparable to

general population. Data suggests that in middle-age HIV positivity

is associated with fall risk, potentially due to the underlying



STOPP/START version 2: development of software applications:

easier said than done?

P. Anrys


, B. Boland


, J.M. Degryse


, J. De Lepeleire


, M. Petrovic,

S. Marien


, O. Dalleur


, G. Strauven, V. Foulon, A. Spinewine




Université catholique de Louvain, Louvain Drug Research Institute,

Clinical Pharmacy Research Group,


Cliniques Universitaires Saint-Luc,

Geriatric Medicine,


Université catholique de Louvain, Institute of Health

and Society,


Department of Public Health and Primary Care, KU Leuven,



Departement Public Hea, KU Leuven


Explicit criteria, such as the STOPP/START criteria, are

used for both clinical practice and research to identify potentially

inappropriate prescribing (PIP). There has been growing interest in the

development of software applications to automatically detect PIP.


In the context of the COME-ON study [1], a software

application was developed to detect PIP instances from the research

database. The detection should be as sensitive and specific as possible

as there is no subsequent evaluation by a clinician. During this process,

some difficulties arose for which decisions had to be taken by the

research team.


We encountered four kinds of issues: 1. Some criteria are

not as explicit as they should be: e.g. the list of anticholinergic drugs

has to be established; some terms are not (precisely) defined:


long-term aspirin

. 2. Specific information that is not easily

available is sometimes required: e.g. information about lack of efficacy,

contraindication. 3. There is no universal coding system for medica-

tions that meets the requirements to apply all criteria: The ATC codes

do not distinguish between medications with different routes of

administration or formulation. For such criteria, coding by the national

identification code is required. 4. In order to improve specificity,

several criteria would benefit from additional rules:



could be added to decreased the risk of false positives.

Key conclusions:

The next version of the STOPP/START criteria could

be enriched to make them more directly transferable to algorithms,

to minimize variations between research teams and to enhance



[1] Anrys P.,

et al.

, Collaborative approach to Optimise MEdication use

for Older people in Nursing homes (COME-ON): study protocol of a

cluster controlled trial.

Implementation Science

, 2016. 11(1).


Predictors of sedentary status in overweight and obese patients

with multiple chronic conditions, a cohort study

M. Joven


, I. Croghan


, D. Schroeder


, S. Quigg


, J. Ebbert


, P. Takahashi




Department of Internal Medicine, Mayo Clinic,


Department of Health

Science Research, Mayo Clinic, Rochester, MN


Obese patients with multiple chronic conditions often

require walking to improve their health. However, these patients may

have barriers to walking. We sought to determine the risk factors at

baseline that impacted sedentary status (<5,000 steps a day) after four

months of some pedometer use.


We conducted a secondary analysis using a cohort design.

Patients over 18 years of age were enrolled with a BMI >25 kg/m



>7 chronic conditions. Primary outcome was <5,000 steps a day on a

pedometer after 4 months. Potential predictors included demograph-

ics, biometrics, comorbid health conditions, self-rated health, and

length of pedometer use. We compared the predictors to sedentary/

non-sedentary status using Pearson chi square or logistic regression.

We created a final multivariable model.


We enrolled 130 patients with an average age of 63.6 years


15). 72% were women and 98% were white. At 4 months, 55% were

sedentary. We observed that increased age, cumulative comorbid

health, BMI, waist circumference, and sedentary baseline status

predicted sedentary status. Reduced self-rated physical activity,

physical quality of life, baseline step count and gait speed all predicted

sedentary status at 4 months as well. In the multivariable model, BMI

and physical QoL were significantly associated with being sedentary

(p values of 0.014 and 0.03 respectively).


We observed that lower physical QoL and higher BMI

were associated with being sedentary after pedometer use. This study

outlines potential barriers to future activity with pedometers.

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