European Geriatric Medicine - Supplement 1 - Volume 6

Poster presentations / European Geriatric Medicine 6S1 (2015) S32

–

S156

S109

Results:

After 6 months of follow-up, the cardiac rehabilitation

program coordinated by cardiological and primary care services

for heart failure patients improved quality of life, and increased

exercise tolerance, active employment, and the number of

participants who quit smoking. The mixed program also reduced

body mass index. The results of this study demonstrate that a

multidisciplinary cardiac rehabilitation programme can improve

symptoms, functional performance and health-related quality of life

in older patients with heart failure. These benefits are associated

with a reduction in hospital admissions attributable to heart

disease.

Conclusions:

Not all patients with heart failure are suitable for

such an exercise programme and clearly this care component needs

to be tailored to the individual. However, we believe that cardiac

rehabilitation should become an important part of the care of heart

failure patients. Cardiac rehabilitation offers an effective model of

care for older patients with heart failure in Primary Care.

Project funded by EEA Grants (NILS Movility Project).

P-289

J.H. Downton scale and rehabilitation effectiveness: may be

related?

M. Mart´ın Montagut

, C. Roqueta Guill ´en

, M. Cabello Gimenez

P. Rodr´ıguez Rodr´ıguez

, M.C. Guerrero G ´omez

, J.C. Macarro

Rodr´ıguez

, M. Riera Ca˜nadell

Parc de Salut Mar. Centre F`orum, Barcelona, Spain

Aim:

Relationship between J.H. Downton scale at admission and

effectiveness on functional ability in patients admitted to an

intermediate care unit.

Patients and Methods:

Prospective study of patients admitted from

1st of January 2014 until 31st of November of the same year.

Barthel index at admission (BIA), Barthel index at discharge (BID)

and J.H. Dowton scale at admission were registered. J.H. Downton

scale values the risk of falling and consists of the following items:

previous falls, cognitive status, sensory deficit, drugs and walking

ability (score range: high risk: ≥3; moderate risk: 2; low risk:

2).

Functional improvement was assessed using the absolute functional

gain (AFG) and was calculated by the difference between BID

and BIA (adequate rehabilitation effectiveness was considered a

AFG

20 points).

Results:

Five hundred and thirty-five patients were registered

(60.1% women). Mean of AFG was 29.6

25.6. Five hundred and

three (94.0%) patients had high risk of falling valued by the

J.H. Downton scale, 27 (5.0%) moderate risk and 5 (0.9%) low risk.

From 338 patients who attained an AFG

20 points, 318 (94.1%)

had high risk of falling, 7 (5.0%) moderate risk, and 3 (0.9%) low

risk; the remaining 197 (36.8%) (AFG ≤20), 185 (93.9%); 10 (5.1%)

and 2 (1.0%), respectively (p = 0.988).

Conclusions:

Most of the patients admitted to the intermediate

care unit had a high risk of falling assessed by J.H. Dowton scale.

No significant relationship between J.H. Dowton scale at admission

and adequate effectiveness on functional ability was found.

P-290

Might be the Braden scale a predictor of functional improvement

in patients admitted to an intermediate care unit?

M. Mart´ın Montagut

, C. Roqueta Guill ´en

, M. Cabello Gimenez

P. S ´anchez Mohedano

, A. Molina Tierraseca

, M. ´A. Garc´ıa

V ´azquez

, M. Riera Ca˜nadell

Parc de Salut Mar. Centre F`orum, Barcelona, Spain;

Parc de Salut

Mar. Centre F`orum, Barcelona

Aim:

Relationship between Braden scale at admission and

effectiveness on functional ability in patients admitted to an

intermediate care unit.

Patients and Methods:

Prospective study of patients admitted from

1st of January 2014 until 31st of november of that year. Barthel

index at admission (BIA), Barthel index at discharge (BID) and

Braden scale at admission were registered. Braden scale assesses the

risk of developing pressure ulcer (PU) and consists of the following

items: sensory perception, skin exposure to moisture, physical

activity, mobility, nutrition and skin friction. The score range:

≤12 points: high risk, 13–14: moderate risk, 15–16 (if

75 years

17–18): low risk and

17: without risk. Functional improvement

was assessed using the absolute functional gain (AFG) and was

calculated by the difference between BID and BIA (adequate

rehabilitation effectiveness was considered a AFG

20 points).

Results:

Five hundred and thirty-five patients (60.2% women) were

recorded. Mean of AFG was 29.7

25.6. Twenty-six (4.9%) patients

had high risk of PU valued by the Braden scale, 61 (11.4%) moderate,

199 (37.2%) low and 249 (46.5%) had no risk. From 338 (63.2%)

patients who attained a AFG

20 points, 4 (1.2%) had Braden scale

suggestive of high risk of developing pressure ulcers; 24 (7.1%)

moderate risk; 109 (32.2%) low risk and 201 (59.5%) had no risk;

the remaining 197 (36.8%) (AFG≤20), 22 (11.2%); 37 (18.8%); 90

(45.7%) and 48 (24.4%), respectively (p

0.0001).

Conclusions:

Patients who obtained an adequate functional

improvement had higher scores on the Braden scale at admission,

i.e. low risk or no risk of developing PU during admission.

P-291

Consequences of a health reform on short term mortality

in elderly hip fracture patients; results from a quality registry

M.I. Martinsen

, A.H. Ranhoff

, E. Sivertsen

Diakonhjemmet Hospital, Oslo, Norway

Objectives:

In January 2012, a national health reform was

implemented in Norway and the number of hospital beds

decreased, resulting in shorter length of stay (LOS). The aim here

is to describe consequences of this reform focusing on LOS, on

short-term mortality in elderly hip fracture patients.

Method:

Cross-sectional observational study. Data was obtained

from a quality registry where demographic and medical information

are collected by an interdisciplinary team. Data about time of

death were obtained from the National Population Registry. Short-

term mortality was defined as time of death within 30 days after

discharge from hospital.

Results:

2353 patients with hip fracture, 65+ years were included

from 01.01.2007 to 31.12.2014. Patients who died in hospital

and patients admitted from nursing homes were excluded. There

proportion of men admitted before the reform was 24% vs 26% after

(p = 0.38). Mean age was 84 years, the same in both groups, while

there were more patients within ASA-score group 3–5 before the

reform than after, 51% vs 46%, p = 0.034. LOS decreased from mean

13(

8.5) days before the reform to 7(

3.9) days after, p = 0.001.

Short-term mortality before the reform was 3.5% vs 5.6% after,

p = 0.017 (CI 1.09–2.40, OR 1.6). We found no significant association

between LOS and short-term mortality, p = 0.42.

Conclusions:

Short-term mortality increased for patients admitted

from their homes after the reform. We did not find a significant

association between LOS and the increased mortality in this study.

Further studies on LOS and the risk of short-term mortality needs

to be studied.

P-292

Acute geratology wards and stroke patients

K. Metcalfe

, A. Phelps

, S. Thompson

Oxford Medical School, Oxford, United Kingdom;

John Radcliffe

Hospital OUH Trust, Oxford;

University of Oxford, Dept of Clinical

Geratology, Oxford

Objective:

The National Clinical Guidelines for stroke stipulate

that all stroke patients should be cared for in Acute Stroke

Units. With high demand on the Oxford Stroke Unit beds, a

minority of stroke patients needing further rehabilitation, are