European Geriatric Medicine - Supplement 1 - Volume 6 - September 2015

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Poster presentations / European Geriatric Medicine 6S1 (2015) S32–S156 S101
to be elaborated a guidelines for osteoporosis management for
patients with liver transplantation.
P-259
Hematologic parameters in older patients: Results of a German
multicentric anemia prevalence study
M.C. Polidori1 , G. Roehrig2 , Y. R ¨ucker3 , I. Becker4, S. Gebauer 5,
R. Lenzen-Grossimlinghaus6, M.K. Modreker 7, R.-J. Schulz8 ,
H.P. Willscherei9, R. Wirth 10, M. J¨ager11
1University of Cologne, Cologne, Germany; 2Ageing Clinical Research,
Dpt II Internal Medicine, University Hospital of Cologne, Cologne,
Germany; 3St.Marienhospital Cologne Geriatrics Dpt, Cologne,
Germany; 4 IMSIE University of Cologne, Cologne, Germany;
5Dominikus Hospital, Geriatric Department, Berlin, Germany;
6Klinikum Ernst von Bergmann gGmbh, Medical Department of
Geriatrics, Potsdam, Germany; 7 Helios Kliniken Schwerin, Clinic for
Geriatric Medicine and Geriatric Rehabilitation, Schwerin, Germany;
8St. Marien-Hospital, Cologne, Germany; 9Kliniken Essen Mitte,
Clinic for Geriatric Medicine, Essen, Germany; 10Germany; 11 St.
Vinzenz-Hospital Dinslaken, Clinic for Geriatric Medicine, Dinslaken,
Germany
Anemia is highly prevalent among geriatric inpatients. Association
with morbidity and mortality is acknowledged. However, most
ta derive from studies outside Germany. The present study was
initiated by the German Geriatric Society to fill the gap of German
data concerning anemia in geriatric inpatients.
Between June 2013 and December 2014 598 geriatric inpatients
were recruited in 6 participating centers. On admission laboratory
parameters and comprehensive geriatric assessment were collected.
Five hundred fifty-nine of 598 patients could be evaluated (M 188,
32.5%). Anemia was present in 319 patients (55.1%) with 46.9%
to 66% according to center; average Hb was 11.9 g/dl (11.2 to
12.1 g/dl)(p> 0.05). Low albumin (<3.5 g/dl) was present in 71% of
all patients while deficiency of folic acid and VitB12 were found in
6% (<3 ng/ml) and 5.8% (<200 ng/l), respectively. Anemic patients
had significant lower albumin levels (p < 0.004) and significant
lower Barthel Index (p < 0.001); no significant difference was found
respecting other assessment tests (MMSE, TUG, Handgrip).
We conclude that anemia is highly prevalent among German
geriatric inpatients, comparable to US data, thus raising the question
of age adjusted reference values in patients >70 years; anemia
is associated with significant lower albumin levels, confirming
previous data; anemia is associated with significant lower Barthel
Index, emphasizing its negative impact on activity of daily living.
P-260
Pre-malignant and malignant skin lesions in older people
G.-I. Prada1, G. Rijkin2, R.M. Nacu1 , I.G. Fita1 , I.A. Ignat 1,
D.M. Andruta1, A.G. Prada2 , I.D. Alexa3 , A.M. Herghelegiu1
1National Institute of Gerontology and Geriatrics, Bucharest, Romania;
2Bucharest, Romania; 3Iasi, Romania
Objective: Skin lesions are frequently encountered in elderly.
Pre-malignant and malignant lesions raise problems of diagnosis
in early stages. Objective was to identify such skin lesions
characteristic in elderly.
Material and Methods: We investigated 315 older patients with
skin lesions, 56% women, 66% from rural area. Three age-groups
were considered: pre-senescent (50–64 years), young-old (65–74
years), old-old (≥75 years). Risk factors for malignant lesions have
been evaluated.
Results: Pre-malignant and malignant lesions affected most often
feminine gender from rural area (p < 0.05). Pre-malignant lesions:
71% prevalence, most often seborrheic keratosis, followed by actinic
keratosis and dysplastic nevi, the last more prevalent in men
(p < 0.05). Most often malignant lesion: basocellular epithelioma,
followed by spinocellular epithelioma, the latter more frequent in
men (p <0.05). Interestingly, pre-malignant and malignant lesions
were more frequent in young-olds as compared to other age-
groups (p < 0.01). Beyond the age of 75 years, actinic keratosis
was most prevalent (47%). Bowen disease was significantly
more prevalent in pre-senescence (p< 0.01). Most prevalent risk
factors were skin burns, followed by actinic keratosis. Nodular
basocellular epithelioma was most prevalent (41%), and both types
of epithelioma were most frequently located on head (53%), mainly
on cheeks followed by nose. Spinocellular: more frequent on lips.
Most tumors (46%) were between 1 and 2 cm. Most patients (47%)
went to medical examination after > 2 years of evolution. Most
frequent type of melanoma: lentigo maligna.
Conclusions: Skin changes with age favor several pre-malignant
and malignant lesions. They need a careful and early detection in
older people to start adequate therapy.
P-261
A complete audit of blood pressure control in stroke patients
in a geriatric hospital in Malta
P. Zammit1, A. Fiorini2
1Department of Geriatrics, Pieta, Malta; 2The Geriatric Medicine
Society of Malta, Pieta, Malta
The National Institute for Health and Care Excellence (NICE) states
that blood pressure (BP) control in stroke has the same guidelines
as for BP control in high cardiovascular risk patients. The targets
for non diabetic stroke patients are a BP of less than 140/90mmHg
and for diabetic ones a BP of less than 130/80mmHg.
An audit was done in 2009 to show if blood pressure (BP) in
stroke patients is well controlled. A second cycle was repeated in
2015. The cohort of patients selected were those found in geriatric
wards in Malta’s geriatric hospital. Patients who had a very recent
stroke (less than 2 weeks) were excluded from the audit as elevated
BP levels are a common complication of acute stroke and usually
normalise a few days to weeks after the event.
As well as a blood pressure reading by the doctor, epidemiological
data, risk factors and anti-hypertensive medications if any were
collected. Results of the both the first and second cycle showed
that there is good BP control in this cohort of patients in Malta’s
geriatric hospital when compared with the guidelines as well as
studies done in other countries.
P-262
Primary malignant lymphoma of the uterus in an elderly lady
P. Zammit1, I. Perera2, M. Falemara2
1Department of Geriatrics, Pieta, Malta; 2 Mater Dei Hospital, Msida,
Malta
Primary malignant lymphomas of the female genital tract are
rare and less than 1% of these lymphomas occur in the female
genitalia. Most cases are non-Hodgkin lymphomas and diffuse large
B-cell lymphomas are most commonly seen. Patients tend to be
asymptomatic or have nonspecific abdominal symptoms, including
abdominal bloating, pressure, and discomfort. According to reports,
only 17% of non-Hodgkin’s lymphoma patients have constitutional
symptoms such as fever, weight loss and night sweats. The most
common presenting feature of primary uterine lymphoma is vaginal
bleeding, which is similar to that of cervical carcinoma.
We present this rare case of an 81-year-old lady who presented
with abdominal pain and an episode of post menopausal bleeding. A
computer tomography of the abdomen and pelvis showed evidence
of a lymphoproliferative disorder. An endometrial biopsy was taken
which diagnosed a primary diffuse large B cell lymphoma of
the uterus. She was started on chemotherapy with an R-CEOP
protocol (Rituximab, Cyclophosphamide, Etoposide, Vincristine and
Prednisolone). Currently the patient is stable and is receiving
further cycles of chemotherapy.