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Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
S147
patients and relatives. Twenty-two respondents had involvement
in the geriatricians’ ward rounds and all those felt these were
of excellent quality. Twenty-two respondents had involvement in
Harm Free Care and weekend handover and all felt it was of
excellent quality.
Qualitative responses were assessed and a word cloud obtained.
Amongst the reactions worth highlighting: “It has significantly
improved patient care, reduced inpatient complications and
improved communications with patients and families. It provided
outstanding training and teaching opportunities”.
Conclusions:
Geriatricians’ input on orthopaedic wards is viewed
positively for staff satisfaction and multidisciplinary team work.
P-429
Gait speed as predictor of outcomes of elective cardiac surgery
in older patients
P. Betomvuko
1
, I. Michaux
1
, L. Gabriel
2
, B. Bihin
1
, M. Gourdin
2
,
M. De Saint Hubert
1
1
CHU Mont-Godinne, UCLouvain, Namur Research Institute for Life
Science, Yvoir, Belgium;
2
CHU Mont-Godinne, UCLouvain, Namur
Research Institute for Life Science, Yvoir
Objectives:
Cardiosurgical risk can be assessed using the
EuroSCORE. In older patients, increasing evidence suggests that
such risk assessment should include frailty status. We hypothesised
that preoperative gait speed, as an indicator of frailty, may
contribute to predict postoperative mortality.
Methods:
Older patients aged ≥75 years consecutively admitted
for elective cardiac surgery (valvular, coronary, both, TAVI) were
recruited. EuroSCORE and gait speed were measured. Demographic
data, Edmonton Frail Scale (EFS), functional status, comorbidity
and mortality (1 and 3 months) were recorded. Data were analysed
using independent t-tests and ROC curves were constructed to
measure the accuracy of the gait speed for 1- and 3-month
mortality.
Results:
Full data for follow-up and gait speed were available for
94 patients (mean age 79.8
±
3.5, 47.3% were female); 56/94 were
independent for ADL. Mean EFS was 6.8
±
3.1. Mean gate speed was
0.64
±
0.2m/s. One- and 3-month mortality was 4/94 (4.2%) and 5/94
(5.3%) respectively. Gait speed was significantly higher in survivors
compared with non-survivors at 1 (0.68
±
0.23m/s vs 0.43
±
0.06m/s,
p = 0.037) and 3 months (0.68
±
0.23m/s vs 0.46
±
0.07m/s, p = 0.034).
Area under the ROC curve for prediction of 1-month mortality
by preoperative gait speed was 0.86, 95% CI: 0.77–0.92 and 0.83,
95% CI: 0.74–0.90 for 3-month mortality.
Conclusions:
In older patients admitted for elective cardiac
surgery, preoperative gait speed was significantly associated with
1- and 3-month mortality. In older patients, composite index
including EuroSCORE and gait speed might increase the accuracy in
mortality prediction. Further analyses combining both parameters
and determining cut-offs values are needed.
P-430
Geriatrician’s skills are recognised and valued on general
surgical wards. POPS-SG, perioperative older people undergoing
surgery
–
Salford General Surgery
H. Bruce
1
, D. Mountford
1
, J. Fox
1
, A. Vilches-Moraga
1
, Z.R. Alio
1
,
E. Feilding
1
, M.K. Peeroo
1
, K. Wardle
1
1
Salford Royal NHS Foundation Trust, Salford, Manchester, United
Kingdom
Objectives:
Increasing numbers of older people are undergoing
surgery as a result of an ageing population and advancing
techniques. Although benefits of surgery are comparable in both
older and younger people, the former are more likely to experience
medical complications.
In ‘An Age Old Problem’ (2010), it is recommended that ‘routine
daily input from Medicine for the Care of Older People should be
available to elderly patients undergoing surgery’.
After introducing an elderly medicine liaison service to our general
surgical wards, we assessed its impact on staff.
Methods:
An elderly medicine liaison service delivered by 2
consultant geriatricians was introduced to our general surgical
wards in September 2014; consisting of comprehensive geriatric
assessment, multidisciplinary interventions, daily medical patient
reviews and weekly multi-disciplinary team meeting.
An anonymous e-survey aiming to assess the impact of the service;
was completed in the second half of April 2015 by surgical doctors,
allied health professionals (AHPs) and nursing staff.
Results:
30 responses were received (14 doctors and 16 nurses
and AHPs). All respondents 30 (100%) felt that patients benefitted
from the service. Of those who had attended a MDT meeting, 16
(100%) felt this was useful. Thirteen (94%) junior doctors felt they
benefitted educationally from the service.
Conclusions:
An elderly medicine in reach service into general
surgery is viewed positively on surgical wards seven months after
its deployment; with perceived clinical and educational benefits for
patients and staff respectively.
P-431
Geriatrician’s skills are valued and bring quality to a major
trauma service. POPS-ST, perioperative care of older people
undergoing surgery
–
Salford Trauma
E. Feilding
1
, M.K. Peeroo
2
, J. Fox
2
, Z.R. Alio
2
, K. Wardle
2
,
A. Vilches-Moraga
2
1
Salford Royal NHS Foundation Trust, Salford, United Kingdom;
2
Salford Royal NHS Foundation Trust, Salford, Manchester, United
Kingdom
Objectives:
The rate of older people admitted to hospital
following a major trauma is increasing. Comorbidity, polypharmacy,
functional and cognitive impairment are a common occurrence,
these individuals require longer hospital stays and develop more
complications.
In order to improve the outcomes of ‘Silver trauma’ patients, an
elderly care in reach service was deployed in September 2014
(POPS-ST, perioperative care of older people undergoing surgery –
Salford Trauma).
We aimed to assess the impact of our consolidated POPS-ST Service
on staff.
Methods:
Older major trauma and spinal patients undergo
comprehensive geriatric assessment, daily medical reviews and
regular multidisciplinary meetings.
An anonymous electronic survey was sent out in March 2015
inviting healthcare professionals to provide their opinion of the
service.
Results:
We received 30 replies; 10 of these were from consultants
and the rest from nurses, junior doctors, support staff and
therapists. Most interviewees were aware of the service (26/30). All
those who replied to our survey felt the in reach Elderly care Service
either greatly improved (88%) or improved (12%) patient care. Most
responders (83%) benefitted educationally from interaction with
the geriatricians.
Qualitative responses were assessed and a word cloud obtained.
Amongst the reactions worth highlighting: “excellent source of
knowledge for all health care professionals” and “a genuine and
invaluable service to very vulnerable people”.
Conclusions:
An elderly medicine in reach service for older trauma
patients is viewed positively by staff seven months after its
deployment; it is felt to benefit service users and act as a valuable
educational resource.