43 / 210
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
S35
Methods:
A cohort of 63 patients, 100 years of age and
older, admitted to Internal Medicine, from 2008 to 2012, were
retrospectively studied. Demographic information, comorbidities,
recent admissions, clinical and laboratory data were recorded from
each patient.
Results:
Of these 63 patients, with a mean age of 101.1
years, 57 (90.5%) were women. The main reasons for admission
were respiratory infection (68.3%), especially healthcare-associated
pneumonia (38.1%), and urinary infection (12.7%). The most
commonly identified comorbidities were hypertension (58.7%),
heart failure (54.0%), atrial fibrillation (33.3%), severe chronic renal
disease (28.6%), respiratory disease (28.6%), diabetes (15.9%) and
pressure ulcers (12.7%). Cumulative in-hospital, 30- and 90-day, 6-
and 12-month mortality rates were 36.5%, 60.3%, 74.6%, 81.0% and
85.7%, respectively. After one year 9 patients survived. Of these,
only 1 patient was institutionalized, none had diabetes, pressure
ulcers or severe chronic kidney disease. Laboratory tests associated
with mortality at 12 months were renal biomarkers (creatinine,
BUN) and fasting glicemia.
Conclusions:
Centenarians are usually very fragile patients,
hospitalization for acute illness often seems to have devastating
consequences in this population. In our study, short and long-term
mortality among hospitalized centenarians was extremely high.
Long-term poor outcome was associated with institutionalization,
kidney function and blood glucose levels.
P-012
Double-knotted jejunal tube of a percutaneuos endoscopic
jejunostomy
M. Gogol
1
, A. Dettmer-Fl ¨ugge
1
, C. Winkler
1
1
Hospital Lindenbrunn, Coppenbruegge, Germany
Background:
Enteral tubes are a common clinical practise for
administration of nutrition, fluids and drugs. A knotted jejunal tube
of a PEJ is a rare but serious complication and a double-knotted
tube isn’t described yet.
Case:
A 72 years old man received a PEGJ in May 2013 for
fluctuation of his motor function due to Parkinson’s disease
which was diagnosed 15 years earlier. In June 2013 therapy with
continuous levodopa enteral infusion (Duodopa
®
) was started and
well tolerated. In July 2014 the patient worsened again and an
occlusion of the jejunal tube was detected and the tube was
replaced. X ray control stated a correct position of the jejunal tube
tip. Five weeks later the patient worsened again and endoscopy
revealed a double-knotted tube end located in correct position. The
tube was retracted in the stomach and unknotted with a forceps.
After unknotting and full retraction a new jejunal tube was inserted
without complication and the patient was discharged home. No
further complication occur until today.
P-013
Choosing Wisely and geriatric medicine
M. Gogol
Hospital Lindenbrunn, Coppenbruegge, Germany
In 2011 the American Board of Internal Medicine (ABIM) started the
Choosing Wisely campaign to promote more discussions between
physicians and patients (or proxies) about decision making in
medicine and to reduce procedures and therapies which are not
necessary or harmful for patients. The American Geriatrics Society
(AGS) and the American Medical Director Association (AMDA)
participated in this initiative and AGS (JAGS2013;61:622–631
and 2014;62:950–960) and AMDA (JAMDA 2013;14:639–641 and
http://www.choosingwisely.org/clinician-lists/)both published 10
recommendations about things that should discussed and avoided.
Furthermore some scientific societies published recommendatios
regarding elderly patients too. In Germany a similar initiative
started in 2015 by the German Society of Internal Medicine (DGIM)
and will address topics of overuse and underuse. The German
Society of Geriatrics (DGG) was invited to adress possible points
for the German health care system for elderly patients and a first
meeting of the DGIM and her specialities was held in May 2015
in Berlin. In parallel there are activities of the German Union of
Medical Scientific Societies (AWMF) to adress this point to. The
different approaches to this topic will be discussed in this Poster
presentations and all participants of the meeting are invited to
participated on a survey at the Poster presentations board to rate
the US recommendations.
P-014
Age differences in acute stoke: a retrospective comparison
study across geriatric and non-geriatric patients
E. Goz
1
, T. Kahrman
1
, A. Genc
1
, V. Ozturk
1
, M.K. Kutluk
1
1
Dokuz Eylul University, Izmir, Turkey
Objectives:
The incidence of stroke is increasing primarily in
relation to the aging population. Numerous studies have reported
associations between age and poor outcomes. However, it is
important to know the clinical differences between geriatric and
non-geriatric patients to organize a better acute stroke care. The
aim was to compare differences between geriatric and non-geriatric
patients with acute stroke.
Methods:
Medical records of patients with stroke, who were
hospitalized from October 2011 to October 2013, were extracted
from the medical registry database of the university hospital.
Information about age, gender, stroke type, tissue plasminogen
activator treatment, aphasia, length of stay, number of co-
morbidities, physiotherapy, and muscle strength at onset were
recorded.
Results:
In total, the records of 906 patients were included in
the study. There were 663 (73.2%) geriatric (age≥65 years) and
243 non-geriatric patients. The prevalence of ischemic stroke was
88.6%. The muscle strength of upper and lower limbs at onset were
significantly lower (Mann–Whitney U test, p
<
0.001), number of
comorbidities and female patients, and presence of infection were
significantly more (t-test and chi-square test, p
<
0.001) in geriatric
patients than non-geriatrics. There were no significantly differences
between the groups in terms of stroke type, tissue plasminogen
activator treatment, aphasia, physiotherapy referral, and length of
stay (chi-square test and t-test, p
>
0.05).
Conclusions:
Geriatric patients with acute stroke are mostly female
and have poor muscle strength, higher number of comorbidities,
and prevalence of infection after stroke. These factors should
be taken into consideration in the acute stroke care of geriatric
patients.
P-015
Development of patient satisfaction questionnaire evaluating
‘Early Discharge
–
Hospital at Home’ in elderly
M. Gregersen
1
, E.M. Damsgaard
1
1
Department of Geriatrics, Aarhus University Hospital, Aarhus C,
Denmark
Objectives:
Early Discharge – Hospital at Home (EDHH) is a care
model designed to deliver acute medical care in the patient’s home
as a substitute for acute hospitalization. Patient satisfaction is of
major importance to evaluate EDHH. The aim of this study was to
develop a patient satisfaction questionnaire.
Methods:
Target population was 75+ year-old acute medical
patients, admitted to medical emergency ward at Aarhus University
Hospital, transferred to a geriatric ward, and/or to EDHH. Ten
semi-structured interviews were undertaken and led by a neutral
investigator. Each interview lasted 45 minutes and took place
in the patient’s home approximately 2 weeks after discharge.
All interviews were tape-recorded and transcribed. Categories of
importance were grouped into themes. A 5-point Likert scale was