Area: Comprehensive geriatric assessment

276 Pages·2017·3.83 MB·English

Abstractsofthe
13th International Congress of the
European Union Geriatric Medicine Society –
Developing Preventive Actions in Geriatrics
20–22 September 2017, Nice, France
Authorsareresponsibleforcontentandlanguagequalityofabstracts
PublishedasSupplement1to
EuropeanGeriatricMedicine,Volume8,2017
EDITOR-IN-CHIEF
J.-P. Michel, Emeritus professor of geriatric medicine, Geneva University, Switzerland, Past EUGMS president, WHO expert aging and life course program,
Member of the French Academy of Medicine.
[email protected]
ASSOCIATE EDITORS
M. Barbagallo, Full professor, Università degli Studi di Palermo, Palermo, Italy. International Association of Gerontology and Geriatrics, Clinical Director European
section
A. Benetos, Full professor of geriatric medicine, University of Nancy, France, Academic director of the EUGMS (2014-2017)
J. Bousquet, Emeritus professor of medicine University of Montpellier, France, Offi cial representative of the European Innovative Partnership, Active Healthy
Ageing, European Community, Brussels
A.J. Cruz-Jentoft, Head of the geriatric department, University Hospital Ramón y Cajal, Madrid, Spain, Past EUGMS president
S. Maggi, Research Director, Institute of Neuroscience, Aging Branch-Padua, Italy, President EUGMS, 2016-2017
F. Martin, Professor of Medical Gerontology, King’s college, London; elect-EUGMS President 2018-2019
T. Strandberg, Full professor of geriatric medicine, University of Helsinki, Finland, EUGMS immediate past president 2014-2015
N. Van Den Noorgate, Professor of Geriatric Medicine, Head of the geriatric department, Ghent University, Ghent, Belgium; President of the European Academy
for Medicine of Ageing (EAMA).
EDITORIAL BOARD
J.-P. Baeyens (University of Luxembourg Kirchberg, Luxembourg), H. Blain (University of Montpellier, France), C. Bollheimer (University of Aix-la-Chapelle,
Germany), M. Bonnefoy (University of Lyon-Sud, Lyon, France), M. Cankurtaran (University of Ankara, Turkey), T. Chevalley (University of Geneva, Switzerland),
A. Cherubini (Instituto Nazionale di Riposo e Cura per Anziani, Ancona, Italy, EUGMS academic board member), S. Conroy (University of Leicester, UK),
P. Crome (University College London, UK), A.W. Ekdahl (University of Linköping, Linköping, Sweden, EUGMS executive board member), J. Flamaing (University
of Leuven, Leuven, Belgium), M. Gogol (Lindenbrunn, Germany), T. Grodzicki (Jagiellonian University, Krakow, Poland. EUGMS academic board member),
K. Kinugawa-Bourron (Pierre & Marie University, Sorbonne-Paris-Cité Universities, EUGMS academic board member), T. Kostka (University of Łódz´, Poland),
F. Muller (University of Geneva, Switzerland), D. O’Neill (EUGMS past president, Dublin, Ireland), J. Petermans (University of Liège, EUGMS executive board
member), M. Petrovic (University of Ghent, EUGMS academic board member), K. Pitkälä (University of Helsinki, Helsinki, Finland, EUGMS academic board
member), A.A. Sayer (University of Newcastle upon Tyne, UK, EUGMS academic board member), G. Sergi (University of Padova, Italy), C. Sieber (University
Friedrich-Alexander d’Erlangen-Nuremberg-Germany, EUGMS academic board member), E. Topinkova (Charles University in Prague, Czech Republic, past
clinical director of the IAGG-ER), A. Ungar (University of Florence, Italy), M. Verny (Pierre & Marie University, Sorbonne-Paris-Cité Universities, Paris, France),
A. Vilches-Moraga (Salford Royal NHS Foundation Trust Ageing and Complex Medicine Directorate, Salford, UK, EUGMS executive board member)
INTERNATIONAL EDITORIAL BOARD
H. Arai (Director of the National Center of Gerontology and Geriatrics, Nagoya, Japan), O. Beauchet (MacGill University, Montréal, Quebec, Canada),
C.A. Cano-Gutierrez (Pontifi cia Universidad Javeriana, Santa Fe de Bogotá, Colombia), P. Chan (Capital University of Medical Sciences, Beijing, China),
L.-K. Chen (National Yang Ming University, Taiwan), B. Dong (University of Sichuan, China), C. Kyung-Hwan (Korea University College of Medicine, Seoul,
Korea), T. Fulop (University of Sherbrook, Sherbrook, QC, Canada), L.M. Gutierrez Robledo (Director of the National Institute of Aging of Mexico, Mexico),
J. Li (Director of the National Institute of Gerontology, Beijing, China), P.P. Marin Larrain (Past IAGG president, Central and South America, Santiago, Chile),
X. Li (General Hospital of Chinese People’s Liberation Army, China), F. Morales Martinez (University of Costa Rica, San Jose, Costa Rica), J.E. Morley (Saint
Louis University School of Medicine St. Louis, Missouri, USA), J. Ouslander (Florida Atlantic University, Boca Raton, Florida, USA), M.P. Paixo Junior (Federal
University of Rio de Janeiro, Rio de Janeiro, Brazil), J. Tao (Sun Yat-Sen University, Guangzhou, China)
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EuropeanGeriatricMedicine8S1(2017)v–vi
Abstractsofthe13thInternationalCongressoftheEuropeanUnionGeriatricMedicineSociety–
DevelopingPreventiveActionsinGeriatrics
20–22September2017,Nice,France
FortheCongressProgram,pleaserefertohttp://www.eugms.org/2017.html
Contents
Oralpresentations ......................................................................................................... S1
Area:Comprehensivegeriatricassessment ...................................................................................... S1
Area:Cognitionanddementia ................................................................................................... S6
Area:Frailtyandsarcopenia ..................................................................................................... S8
Area:Geriatricrehabilitation .................................................................................................... S9
Area:Frailtyandsarcopenia ..................................................................................................... S10
Area:Geriatricrehabilitation .................................................................................................... S10
Area:Comorbidityandmultimorbidity .......................................................................................... S10
Area:Comprehensivegeriatricassessment ...................................................................................... S13
Area:Psychiatricsymptomsandillnesses ....................................................................................... S14
Area:Comprehensivegeriatricassessment ...................................................................................... S15
Area:Pharmacology ............................................................................................................. S15
Area:Biogerontologyandgenetics .............................................................................................. S17
Area:Cognitionanddementia ................................................................................................... S18
Area:Pharmacology ............................................................................................................. S19
Area:Ethicsandendoflifecare ................................................................................................. S20
Area:Pharmacology ............................................................................................................. S20
Area:Ethicsandendoflifecare ................................................................................................. S21
Area:Preandpostoperativecare ................................................................................................ S22
Area:Cognitionanddementia ................................................................................................... S24
Area:Acutecare ................................................................................................................. S26
Area:Longevityandprevention ................................................................................................. S27
Area:Metabolismandnutrition ................................................................................................. S27
Area:Acutecare ................................................................................................................. S28
Area:Metabolismandnutrition ................................................................................................. S28
Area:Acutecare ................................................................................................................. S28
Area:Comorbidityandmultimorbidity .......................................................................................... S29
Area:Organisationofcareandgerotechnology .................................................................................. S30
Area:Longevityandprevention ................................................................................................. S32
Area:Oralanddentalhealth ..................................................................................................... S33
1878-7649/©2017ElsevierMassonSASandEuropeanUnionGeriatricMedecineSociety.Allrightsreserved.
vi Contents/EuropeanGeriatricMedicine8S1(2017)v–vi
Area:Infectiousdiseasesandvaccines ........................................................................................... S33
Area:Preandpostoperativecare ................................................................................................ S34
Area:Infectiousdiseasesandvaccines ........................................................................................... S34
Area:Preandpostoperativecare ................................................................................................ S35
Area:Geriatricsinorgandisease ................................................................................................ S36
Area:Urologyandcontinencemanagement ..................................................................................... S37
LateBreakingAbstracts–Oralpresentations .................................................................................... S38
Posterpresentations ...................................................................................................... S40
Area:Biogerontologyandgenetics .............................................................................................. S40
Area:Cognitionanddementia ................................................................................................... S42
Area:Comorbidityandmultimorbidity .......................................................................................... S60
Area:Comprehensivegeriatricassessment ...................................................................................... S72
Area:Delirium ................................................................................................................... S85
Area:Ethicsandendoflifecare ................................................................................................. S91
Area:Frailtyandsarcopenia ..................................................................................................... S96
Area:Geriatriceducation ........................................................................................................ S115
Area:Metabolismandnutrition ................................................................................................. S121
Area:Organisationofcareandgerotechnology .................................................................................. S133
Area:Acutecare ................................................................................................................. S143
Area:Geriatricrehabilitation .................................................................................................... S164
Area:Geriatricsinorgandisease ................................................................................................ S176
Area:Infectiousdiseasesandvaccines ........................................................................................... S186
Area:Longevityandprevention ................................................................................................. S194
Area:Oralanddentalhealth ..................................................................................................... S209
Area:Pharmacology ............................................................................................................. S211
Area:Preandpostoperativecare ................................................................................................ S224
Area:Psychiatricsymptomsandillnesses ....................................................................................... S236
Area:Urologyandcontinencemanagement ..................................................................................... S240
Area:Geriatricsinorgandisease ................................................................................................ S243
LateBreakingAbstracts–Posterpresentations .................................................................................. S243
AuthorIndex ................................................................................................................ S249
EuropeanGeriatricMedicine8S1(2017)S1–S39
Oral presentations
MPI at admission as MPI-1 = 167 patients (15.6%), MPI-2 = 482
Area:Comprehensivegeriatricassessment patients(45.0%)andMPI-3=413patients(38.6%).MPIsignificantly
predicted one-year all-cause mortality (MPI-1 = Hazard Ratio 1.0
reference; MPI-2 = HR 2.79, 95% CI: 1.56–4.97, MPI-3 = HR 6.49,
O-001 95% CI: 3.69–11.4, p-for-trend <0.0001) with good accuracy (ROC
MultidimensionalPrognosticIndex(MPI)predictspost- curve = 0.75, p<0.001). Moreover, MPI grade was significantly
dischargehealth-careoutcomesinhospitalizedolderpatients: associatedwithaccesstoHome-CareServices(MPI-1=OddsRatio
aninternational,multicentre,one-yearfollow-upstudy. 1.0 reference; MPI-2 = OR 2.47, 95% CI: 1.5–4.0, MPI-3 = OR 1.82,
TheMPI_AGEEuropeanProject 95% CI: 1.1–3.0, p=0.002) and to Nursing Home (MPI-1 = OR 1.0
reference;MPI-2=OR2.2,95%CI:1.3–3.8,MPI-3=OR1.7,95%CI:
C.Musacchio1,J.Daragjati2,E.Topinkova3,A.Cruz-Jentoft4,
0.9–2.9,p=0.002)duringtheone-yearfollow-upperiod.
M.C.Polidori5,M.Paccalin6,A.Greco7,F.Mattace-Raso8,
Conclusion: MPI predicts long-term mortality with high-grade of
A.A.Mangoni9,M.Puntoni10,T.Brunet6,R.Custureri1,A.Egbert8,
accuracy. Moreover, MPI stratification may identify older patients
A.Mangiacotti7,H.Michalkova3,C.Miret4,K.Ruxton9,
whoneedaccessinHome-CareServicesandNursingHomesafter
M.Simonato2,A.Pilotto11,onbehalfoftheMPI_AGEProject
hospitaldischarge.
Investigators.1GeriatricsUnit,Dept.ofGeriatricCare,OrthoGeriatrics
&Rehabilitation,FrailtyArea,E.O.GallieraHospital,Genova,Italy;
O-002
2GeriatricsUnit,AULSS6Euganea,SAntonioHospital,Padova,Italy;
Self-ratedhealthasapredictorofmid-termandlong-term
3Dept.ofGeriatrics,FirstFacultyofMedicine,CharlesUniversity,
mortalityinolderAfro-Caribbeanshospitalisedviathe
Prague,CzechRepublic;4HospitalUniversitarioRamónyCajal,
emergencydepartment
Madrid,Spain;5AgeingClinicalResearch,Dept.ofMedicineII,
UniversityHospitalofCologne,Germany;6GeriatricsDepartment L.Godaert1,C.Godard-Sebillotte2,L.AllardSaint-Albin1,
UniversityHospitalLaMilétrie,Poitiers,France;7IRCCSCasaSollievo I.Bourdel-Marchasson3,M.Dramé4,J.-L.Fanon1.1University
dellaSofferenza,SanGiovanniRotondo(FG),Italy;8SectionofGeriatric HospitalofMartinique;2MacGillUniversityMontreal;3University
Medicine,Dept.ofInternalMedicine,ErasmusUniversityMedical HospitalofBordeaux;4UniversityHospitalofReims
Center,Rotterdam,TheNetherlands;9Dept.ofClinicalPharmacology,
Aim:Todeterminewhetherself-ratedhealth(SRH)isanindepen-
FlindersUniversity,Adelaide,Australia;10ClinicalTrialUnit,Scientific
dent prognostic factor for mid- and long-term mortality in older
Directorate,E.O.GallieraHospital,Genoa,Italy;11GeriatricsUnit,Dept.
Afro-Caribbeanpatientshospitalisedforanacutecondition.
ofGeriatricCare,OrthoGeriatrics&Rehabilitation,FrailtyArea,E.O.
Methods: This study was a prospective cohort that recruited pa-
GallieraHospital,Genova,ItalyandGeriatricsUnit,AULSS6Euganea,
tients from the University Hospitals of Martinique Acute Care for
SAntonioHospital,Padova,Italy
Elders(ACE)unit(FrenchWestIndies)fromJanuarytoJune2012.
Background: The MPI_AGE is a European project aimed to iden- Patients aged 75 or older and hospitalized for an acute condition
tify the most cost-effective health interventions according to the wereeligible. The primaryoutcomewas timetodeath withinthe
individual prognostic mortality-risk profile by using Comprehen- 36-week follow-up. SRH was the explanatory variable of interest.
sive Geriatric Assessment (CGA) to calculate Multidimensional Demographicandclinicalcharacteristicswererecorded.Cox’sPro-
PrognosticIndex(MPI). portional Hazards model was used to estimate the relationship
Aim:ToevaluatetheusefulnessofMPIinpredictingpost-discharge betweenSRHandmortality.
outcomes,i.e.one-yearmortalityandaccesstoHome-CareServices Results:Intotal,223patientswereincluded;averageage85.1±5.5
and/orNursingHomes. years,mainlywomen(61.4%).Intotal,123patientsreported"very
Methods: Older patients consecutively admitted to nine Geri- goodtogood"health,and100"mediumtoverypoor"health.Crude
atricUnitsacrossEuropeandAustraliaunderwentCGA-basedMPI mortality rates at six months, 1, 2 and 3 years were 30.5%, 34.8%,
assessment, including functional (ADL,IADL), cognitive (SPMSQ), 48.4%,and57.0%,respectively.SRHreachedsignificantrelationship
nutrition(MNA-SF),riskofpressuresores(Exton-SmithScale),Co- for all mortality endpoints, after adjustment for baseline demo-
morbidity(CIRS),drugsandcohabitation.Patientsweredividedin graphic and clinical characteristics. The adjusted hazard ratios for
MPI-1-low-risk,MPI-2-moderate-riskandMPI-3-high-riskofmor- subjectswhoperceivedtheirhealthasmedium,poororverypoor
tality.Time-to-event(Kaplan-MeierandCoxregression)andlogistic was 1.6 to 2.7 times greater than that of subjects who reported
analyseswereperformedadjustingdataforage,gender,diagnosis goodorverygoodhealth.
and hospital center. Area under receiving-operating-characteristic Conclusion: The association between self-rated health and mid-
(ROC)curvewasalsocalculated. tolong-termmortalityinelderlysubjectscouldhaveimplications
Results: 1,069 hospitalized patients were recruited (mean age for clinical practice, particularly in helping practitioners to better
84.1±7.4 years, females = 60.8%) and classified according to the estimateprognosisintheacutecaresetting.
1878-7649/©2017ElsevierMassonSASandEuropeanUnionGeriatricMedecineSociety.Allrightsreserved.
S2 Oralpresentations/EuropeanGeriatricMedicine8S1(2017)S1–S39
O-003 of all explored geriatric domains, except MMSE. Mild anemia was
Effectofgeriatrician-performedcomprehensivegeriatriccare associatedwithfunctionalalteration(p=0.01),riskoffalls(p=0.03),
onhealthcareutilizationinolderpersonsreferredtoa malnutrition(p<0.0001)andearlydeath(p<0.0004).
communityrehabilitationunit Conclusions:Hemoglobinappearedtobeaninterestingbiomarker,
as its value was associated with mortality and altered geriatric
D.Zintchouk1,M.Gregersen1,T.Lauritzen2,E.M.Damsgaard1.
domainsinelderlycancerpatients.Thisassociationremainedwith
1DepartmentofGeriatrics,AarhusUniversityHospital,Denmark;
mild anemia, with consequences frequently underestimated by
2DepartmentofPublicHealth,SectionofGeneralMedicalPractice,
practitioners.
AarhusUniversity,Denmark
Introduction:Personswithgeriatricconditionsaccountforalarge O-005
shareofhealthcareutilization.Theaimofthisstudywastoinvesti- Oropharyngealdysphagiaandfragility:Canitberelated?
gatetheeffectofageriatrician-performedcomprehensivegeriatric
G.Bahat1,O.Yilmaz1,S.Durmazoglu1,C.Kılıç1,B.Aykent2,
care (CGC) on secondary and primary health care utilization in
M.A.Karan1.1IstanbulMedicalSchool;2MarmaraMedicalSchool
olderpersonsreferredtocommunityrehabilitation.
Methods:Thestudywasarandomized,controlledtrialconducted Objective:Oropharyngealdysphagia(OD)andfragilityaregeriatric
in two Danish community rehabilitation units. Inclusion: persons syndromes those are effecting the prognosis. Literature has been
aged 65 or older from home or hospital. Exclusion: persons re- suggested OD may be present in fragile elderly without neurode-
ceivingpalliativecareorassessedbyageriatricianduringthepast generativediseases.WeaimedtoinvestigatetheassociationofOD
month. Intervention group (IG): CGC including medical history, withfragilityinthecommunitydwellingelderly.
physical examination, blood tests, medication adjustment, and re- Methods: Patients admitted prospectively. Participants’ demo-
lated treatment performed by a geriatrician. Control group (CG): graphic datas were recorded. OD screening was done by scanning
standard care with the GPs as back-up. Outcomes were measured theEAT-10questionnairewhichhastwothresholds(≥3and≥15).
within 90 days of follow-up. Primary outcome: inpatient contacts FRAIL Scale was applied to determine the fragility. We performed
(hospital admissions or emergency department visits). Secondary the measurements of BMI, hand grip strength, time and go test
outcomes: days spent in hospital, outpatient contacts, and GPs’ (TUG),usualwalkingspeed,activitiesofdailyliving(ADL),instru-
contacts.Results:368personswererandomized(185toIG/183to mentalADL,MNA-SF.
CG). No significant differences in number of inpatient and outpa- Results: 1138 patients ≥60 years old were enrolled. The mean
tient contacts, days spent in hospital or number of out of hour age was 74.1±7.3. EAT 10 score correlated with age, number of
GP-visitsorphonecallswerefoundbetweenthegroups.Incidence illnesses,numberofmedications,fragility,BMI,handgripstrength,
rateratiosfornumberofdaytimeGPs’consultationsandvisits(0.7, TUG,usualwalkingspeed,ADL,IADLandMNASFaccordingtothe
95%CI:0.6–0.9),daytimephoneandemailconsultations(0.6,95% two thresholds of EAT-10 groups. There were higher incidence of
CI: 0.5–0.7), or other GPs’ services (0.5, 95% CI: 0.4–0.7) were all female gender, number of neurodegenerative diseases in the two
significantlylowerintheIG(p<0.001). thresholdsofEAT-10groups.Inthelinearregressionanalysis,EAT
Conclusions: Geriatrician-performed CGC reduces the primary 10score≥3(n=65,7.6%,p<0.012)andEAT10score≥15(n=33,3.8%,
healthcareutilization,buthasnoimpactonsecondaryhealthcare p<0.001) were found to be correlated with fragility irrespectively
utilization in older persons referred to community rehabilitation ofallcauses.
unitduring90days’follow-up. Conclusion: OD is a common public health problem and can be
difficult to recognize. We have shown that OD increases with
O-004 fragility.Toourknowledge,thisisthelargestserieintheliterature
Anemia,evenmild,isassociatedwithearlydeathandaltered providingdataonindependentassociationofODwithfrailty.
geriatricdomains,inelderlypatientswithcancer
O-006
E.Liuu,A.Jamet,M.-L.Bureau,A.Caupenne,S.Valéro,M.Paccalin.
Malnutritionandcomorbiditiespredictearlymortalityin
CHUdePoitiers,2ruedelaMilétrie,Poitiers,France
elderlypatientswithcancer
Introduction: Anemia is frequent in elderly patients with can-
A.Jamet1,T.Fauchier2,M.Paccalin3,P.Bouchaert4,V.Migeot5,
cer, due to many physio-pathological mechanisms (inflammation,
J.-M.Tourani4,S.Valéro6,E.Liuu3.1PôledeGériatriedePoitiers,
bleeding,ironandvitamindeficiency,bonemarrowfailure,default
CHUdePoitiers,France;2PôleBiologie,PharmacieetSantéPublique,
of hematopoiesis). The aim of this study was to determine the
CentreHospitalierUniversitairedePoitiers,Poitiers,France;3Pôlede
prevalence of anemia and its severity, in geriatric oncology pop-
Gériatrie,CentreHospitalierUniversitairedePoitiers,Universitéde
ulation, and its association with mortality and geriatric domains
Poitiers,Poitiers,France,INSERM,CHUdePoitiers,Universitéde
alterations.
Poitiers,centred’investigationcliniqueCIC1402,Poitiers,France;4Pôle
Methods: Prospective cohort ANCRAGE (ANalyse Cancer et Sujet
RégionaldeCancérologie,CentreHospitalierUniversitairedePoitiers,
AGE) including cancer patients aged ≥75 years, referred to geri-
UniversitédePoitiers,Poitiers,France;5PôleBiologie,Pharmacieet
atric oncology clinic between 2009 and 2015. Anemia severity
SantéPublique,CentreHospitalierUniversitairedePoitiers,Poitiers,
was graded according to World Health Organization criteria: mild
France,INSERM,CHUdePoitiers,UniversitédePoitiers,centre
[women:110–119g/L;men:110–12.9g/L],moderate[80–109],severe
d’investigationcliniqueCIC1402,Poitiers,France;6PôledeGériatrie,
[<80]. Geriatric assessment explored functional domain (assessed
CentreHospitalierUniversitairedePoitiers,UniversitédePoitiers,
with Activities of Daily Livings); fall risk (Timed Get Up and Go
Poitiers,France
Test,One-LegStandingBalanceTest,andfive-repetitionsit-to-stand
test); nutritional status (Mini-Nutritional Assessment and serum Introduction: Few data address the prognoses of elderly patients
albumin);mood(GeriatricDepressionScale)andcognitiveimpair- withcancer.Assessmentofprognosticfactorsmightallowspecific
ment(Mini-MentalStateExamination,MMSE).Earlymortalitywas treatment and personalized medical care. We sought to identify
consideredatthree,sixand12months. factorspredictiveofearlymortality(<threemonths)inthispatient
Results:Of884patientswithavailabledata,392hadanemia(44%): population.
mildin237patients(60%),moderatein151(39%)andsevereinfour. Methods: Prospective cohort included patients aged 75 years and
Anemia was associated with mortality (p<0.0001) and alteration older with solid tumors or hematologic malignancies followed in
Oralpresentations/EuropeanGeriatricMedicine8S1(2017)S1–S39 S3
oncologygeriatricconsultations.Acomprehensivegeriatricassess- Montpellier;3Départementdel’informationmédicale,Centre
ment including sociodemographic data, social status, autonomy, d’Investigationclinique,CHUMontpellier;4DépartementdeMédecine
cognitive status (Mini-Mental Status Evaluation, MMSE), nutrition Générale,FacultédeMédecinedeMontpellier;5UFRSTAPS,Euromov,
(Mini-NutritionalAssessment,MNA),depressionscale,riskoffalls, MontpellierUniversity;6Pôlegérontologie,MontpellierUniversity
and comorbidities (Cumulative Illness Rating Scale for Geriatrics hospital;7Dept.ofinternalmedicineandgeriatrics,Universityhospital
[CIRS-G] score) was performed. Multivariate models were created ofMontpellier,MontpellierUniversity,Euromov,MacviaFrance
with logistic regression at three months, Cox models at six and
Fallsrepresentamajorcauseofburdenanddeathinolderadults.
12 months. Sensitivity analyses were performed using multiple
PatientsvisitingtheMontpellierBalanceandFallPreventionCenter
inputationandthemaximumbiashypothesis.
(BFPC)(EIPonAHAreferencesite)benefitfromaplanforfallsand
Results: A total of 824 patients (mean age, 81.8 years; 48% men)
fracture prevention based on a 3-hour multidimensional assess-
were included; 28% had metastatic cancer. The mortality rates
mentbyageriatrician,aphysiotherapist,anoccupationaltherapist,
were13%,22%,and37%atthree,six,and12months,respectively.
andapodiatrist.134consecutivepatients(meanage,82years;69%
At three months, a MNA score <17 (odds ratio [OR], 8.16, 95%
women)referredbytheirGPtotheBFPCbetweenSept.2014and
confidence interval [CI], 3.47–19.20), CIRS-G score >8 (OR, 2.66,
Sept. 2015 for balance disturbances and with at least one fall in
95% CI, 1.32–5.33), metastasis status (OR, 2.20, 95% CI, 1.27–3.81)
the previous 6 months were followed for 6 months after assess-
were associated with mortality and a higher serum albumin level
ment. Falls number per patient, 3 and 6 months after vs 3 and 6
appearedprotective(OR,0.90;95%CI,0.85–0.94).Nutritionalstatus
monthsbeforeassessment,wassignificantlyreduced[−2.9±−10.3,
was associated with the prognoses throughout follow-up. Cogni-
p<0.0001; −5.2±−20.6; p<0.0001, respectively]. A significant de-
tive impairment (MMSE) <24/30 was specifically associated with
crease was found for falls rate [25% vs 88% (p<0.0001), and 32%
mortalityat12months(p<0.01).
vs100%(p<0.0001),respectively].Severeandminorinjurieswere
Conclusions:Personalizedgeriatricassessmentcanimproveshort-
lower 6 months after vs 6 months before assessment [6% vs 31%,
termtreatmentstrategiesandmanagementofelderlypatientswith
p<0.0001; 8% vs 14%, p<0.05, respectively]. The same trend was
cancer.
observed for major injuries in the subgroup of patients with at
leastafallduringthefollow-up(17%vs37%,p=0.1).Fearoffalling
O-007
wassignificantlyreducedafter6months(p=0.001).Satisfactionof
OlderPeopleShortStayUnit(OPSSU)teamworkingacross
patients or caregivers was high at M6 (90%). Recommendations
emergencyareasreduceslengthofstay(LOS)intheover75s
made to patients were well followed (80%). Walking ability was
R.Lisk,K.Stevenson,P.Watts,R.O’Sullivan,C.Spencer, preserved at M6. Present results show that referral by their GP of
M.Pagkalinawan,K.Reyes,C.Chikusu.ElderlyCareDepartment, older persons who fall to a fall clinic reduces falls incidence, falls
Ashford&St.Peter’sNHSFoundationTrust rate,andinjuriousfalls.
Objectives:Itisrecognisedthattheolderperson,onceadmittedto
O-009
hospital,frequentlyhavealongerlengthofstayandoccupymore
Geriatricfactorsassociatedwithoneyearmortalityaftercardiac
beddaysthanotherpatients,sowefocusedonreducingthelength
surgery
ofstay(LOS)fortheover75s.
Methods: Introduction of Older People Assessment and Liaison G.Chapelet1,M.Paille1,J.N.Trochu2,J.C.Roussel3,G.Berrut1,
Service(OPAL)inOctober2013basedinMAUimprovedthequality L.DeDecker1.1DepartmentofGeriatrics,EA1156–12,Nantes
of care provided in hospital for over 75s, with limited success in UniversityHospital,Nantes,France;2Inserm,UMR1087,Department
reducing LOS.We set out to reduce LOS for over 75s using PDSA ofCardiologyandVasculardiseases,InstitutduThorax,Nantes
cycles which involved amalgamating the existing OPAL team with UniversityHospital,France;3DepartmentofThoracicand
the acute therapy team; senior therapy presence in emergency CardiovascularSurgery,InstitutduThorax,NantesUniversityHospital,
areas; created OPSSU (Dec 2015) with 13 beds expanding to 29 TranslinkEuropeanNetwork,Nantes,France
beds, patient information leaflets emphasizing the ethos of the
Objective: Surgical aortic valve replacement has been shown to
importanceofgettingpatientshomeanddevelopedacultureinthe
improve survival and quality of life in patients with severe aortic
unit"TimetoMove"withpostersontheward.
stenosis.However,cardiologicvariablesareknowntobeassociated
Results: Before the full implementation in Dec 2015, there were
with an increased mortality. As specific geriatric factors are pre-
10,040 over 75 admissions with LOS 8.85 days (Dec 2014–Nov
dominant in this older population, the aim of this study was to
2015) and after full implementation, there were 10,292 over 75
determinegeriatricfactorsassociatedwithoneyearmortalityafter
admissions with LOS 7.66 days (Dec 2015–Nov 2016) – 13.4% re-
a surgical aortic valve replacement for older patients with severe
ductioninLOSsaving10,017beddays.Usingunder75ascontrol,
symptomaticaorticstenosis.
theLOSreducedfrom3.79(Dec2014–Nov2015)to3.54days(Dec
Methods:BetweenJanuary2012andSeptember2014,allpatients
2015–Nov 2016) – only 6.6% reduction in LOS.98.6% (74 patients)
≥75 years referred for a surgical aortic valve replacement after a
mentioned that they were extremely likely/likely to recommend
complete pre-operative evaluation in a university-affiliated center
theservice.
wereretrospectivelyincludedinthisobservationalstudy.Associa-
Conclusions: OPSSU team working across all emergency areas
tionbetweenoneyearmortalitysurgicalaorticvalvereplacement
reducestheLOSfortheover75swithsignificantcostsavings.
and baseline characteristics including cardiac and geriatric factors
wasanalysedbyCoxmodels.
O-008
Results: Mean age of the 197 patients studied was 81.3 years
EffectofanassessmentinaBalanceandFallPreventionCenter
and 48.2% were men. At one year of the intervention, 19 patients
onfallsrate,andfallsandinjuriousfallsincidenceinolder
(9.6%)weredead.Onmultivariateanalysis,previouscardiacsurgery
fallers:abefore/afterstudy
(Hazardratio[HR]=10.47,p=0.03),undergoingconcomitantcardiac
S.Mekhinini1,M.-C.Picot2,A.Jaussent3,J.Rambaud4, surgery(HR=6.22,p=0.03),pulmonaryhypertension(HR=3.73,0.04)
L.P.Bernard5,C.Boubakri6,H.Blain7.1DepartmentofInternal were still associated with one year mortality. Moreover, cognitive
MedicineandGeriatrics,UniversityhospitalandUniversityof impairment defined by mini-mental state examination <24 was
Montpellier;2Départementdel’informationmédicale,CHU alsoassociatedwithoneyearmortality(HR=4.67,p=0.04).