102 / 210
S94
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
with missing data in both hand grip and walking speed, the overall
prevalence of sarcopenia (32.7%; CI 95% 28–37%) steeply increased
with age (p
<
0.001). Patients with sarcopenia were more likely to
have congestive heart failure, cerebrovascular disease, dementia,
and severe ADL disability.
Conclusion:
Based on EWGSOP criteria, prevalence of sarcopenia
is extremely high among acutely ill older adults. The EWGSOP
algorithm, however, might not be suitable for routine clinical use
in patients admitted to acute care wards since many patients are
not able to perform the walking test.
P-233
Analysis of occurrence of geriatric giants during 17 years at
acute geriatric department
P. Weber
1
, H. Meluzinova
2
, H. Matˇejovsk ´a Kubeˇsov ´a
3
, V. Polcarov ´a
4
,
D. Prudius
4
, K. Bielakov ´a
4
1
Masaryk University
–
DIASTOP, Ltd., Brno, Czech Republic;
2
DIASTOP
–
Masaryk University, Brno, Czech Republic;
3
Masaryk University, Brno,
Czech Republic;
4
University Hospital, Brno, Czech Republic
Objectives:
With increasing age the degree of dependency and
occurrence of great geriatric syndromes (GS), the so-called geriatric
giants grow substantially.
Methods:
The prospective cohort study was aimed at conducting
an analysis and comparison of geriatric syndromes (geriatric giants)
among age different groups at admission time to the acute geriatric
department. Setting, participants: Between 1995 and 2012 years we
had altogether 12,210 elderly patients of an average age 80.57.0 y.
(range 65–103 y.) hospitalised at the Department of Geriatrics. We
divided the patient set into three different age subgroups (65–74 y.;
75–84 y. and ≥85 y.; e.g. 21.4%; 47.9% and 30.7%) and compared the
results among them.
Results:
3787 persons (31.0%) were without any GS. Growing
tendency of the occurrence of all the geriatric syndromes in
combinations with increasing age (p
<
0.001) is obvious. Their
occurrence in the above mentioned age different sets was
according to individual geriatric syndromes and sex (female and
male): falls 22.0%,27.8%,39.9% and 20.5%, 27.0%, 36.1%; immobility
26.4%, 29.3%,42.5% and 30.3%, 30.1% and 39.2%; incontinence
38.4%, 50.6%,69.5% and 38.2%, 47.4%,61.8%; dementia and cognitive
impairment 13.4%, 23.4%, 38.1% and15.8%, 24.3%,33.2% respectively.
Age cut-off for geriatric syndromes occurrence based on ROC
analysis is for female sex 83.5–84.5 y. and for male sex 78.5–82.5 y.
Conclusion:
The increasing occurrence of geriatric giants with age
and female gender has crucial importance not only for individuals
and families but also for demands on costs of health and social care
in oncoming decades.
P-234
Prediction of appendicular skeletal muscle mass using
bioelectrical impedance analysis equations in Australians
S. Yu
1
, A. Powell
1
, K. Khow
1
, R. Visvanathan
1
1
The Queen Elizabeth Hospital, Adelaide, Australia
Objectives:
Appendicular skeletal muscle mass (ASM) is an
important diagnostic criterion for sarcopenia in older people.
Bioelectrial impedance analysis (BIA) offers a simple approach
to measure ASM. To date, the performance of internationally
developed BIA prediction equations (PE) in Australians is not
known. The aim of this study was to validate the BIA PEs, against
dual-energy X-ray absorptiometry (DXA) in healthy Australians.
Methods:
195 (age 18–82 years old) healthy Australian Caucasians
from the western suburb of Adelaide were investigated. ASM were
measured using BIA (single frequency) and DXA. Four BIA prediction
equations were assessed for their validity in this Australian
population. Bland-Altman analysis was used to assess the predictive
accuracy of ASM as determined by BIA against DXA.
Results:
For three of the BIA PEs, ASM as derived from BIA
correlated strongly with ASM as determined by DXA (r ranging
from 0.96 to 0.97, p
<
0.001). Of these three, the PE developed
by Sergi et. al. performed the best with the lowest mean bias of
1.09 kg (CI: 0.84–1.34, p-value
<
0.001). For this equation, the 95%
limits of agreement was between −2.50 and 4.68 kg and the root
mean square error was 2.09 kg (CI: 1.72–2.47).
Conclusions:
The BIA PE developed by Sergi et. al. in older Italians
can be used in Australian Caucasians when single frequency BIA is
used.
Geriatric education
P-235
A retrospective review of discharges of older people
investigating contributions of clinical domains to cost of
admissions
R. Abeyratne
1
, A. Ali
2
, A. Blundell
1
1
Nottingham University Hospitals NHS Trust, Nottingham, United
Kingdom;
2
United Kingdom
Objectives:
Despite trainees in geriatric medicine being required
to meet curriculum objectives in management and finance,
and consultants being accountable for departmental expenses,
little formal teaching is received during training. We evaluated
expenditure in domains familiar to clinicians, gaining insight into
awareness and understanding of these areas.
Method:
Using the Patient Level Information and Costing Systems
database, all discharges from the Healthcare of the Older People
department over one week (n = 84) were retrospectively analysed.
The total cost of the admission, drugs, radiology and pathology
investigations and length of stay (LOS) were reviewed.
Results:
Average LOS was 15 days. The average expenditure
on drugs, radiology and pathology was £507.75 per admission
(£175.42, £210.65, £121.86 respectively); average total cost of an
admission was £5,715.62. Further analysis demonstrated the biggest
determinant of total cost was LOS (R2 = 0.65); each additional
day after admission estimated at £316.07. Conversely, LOS had
little statistical explanatory power of cost of drugs, radiology and
pathology (R2 = 0.27, 0.06 and 0.29 respectively). A departmental
survey (n = 27) demonstrated 33% of clinicians accurately estimated
the cost of each additional day in hospital, 30% accurately estimated
the total cost of drugs and radiology, but only 11% accurately
estimated the cost of pathology investigations.
Conclusions:
In our study, LOS is the greatest determinant of the
total cost of an admission. Individual ‘day-to-day’ clinical decisions
impact little on total cost; their significance being in additional
days they add to LOS. Geriatrics training scarcely addresses these
issues, leaving significant gaps in non-clinical training relevant to
delivering optimal patient care.
P-236
The involvement of older patients in medical student education
from the University of Oxford
T. Aquilina
1
, S. Thompson
2
, K. Metcalfe
3
, H. Hughes
4
, L. Sinclair
4
1
University of Oxford, Oxford, United Kingdom;
2
University of Oxford,
Dept of Clinical Geratology, Oxford;
3
Oxford Medical School, Oxford,
United Kingdom;
4
University of Oxford, Oxford
Objectives:
A survey was conducted in the John Radcliffe Hospital
in Oxford, UK, to investigate the involvement of older patients in
medical student teaching, and to gain an insight into which areas
of education patients value most.
Methods:
After obtaining verbal consent, 65 patients over 65 years
were asked to complete a questionnaire on their day of discharge.
Questions included the patients’ level of interaction with medical