44 / 210
S36
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
applied to develop a 15-item satisfaction questionnaire based on the
relevant themes. Cognitive well-functioning elderly were included
and received the questionnaire by mail. As a reminder, the patients
were contacted by telephone to provide help if needed to fill in the
questionnaire.
Results:
The themes of importance were: cooperation between
patient and health-care professionals, communication, information,
feeling safe at home, and inclusion of relatives in treatment
decisions. In total, 99 patients returned the questionnaire which
was 56% of the possible responders. Cronbach’s alpha coefficient,
based on all items, was 0.89 which means good internal consistency.
One item was removed. Baseline characteristics of the responders
were equal to the non-responders’.
Conclusion:
With a reasonable response-rate we were able to
develop a valid questionnaire to evaluate patient satisfaction with
EDHH.
P-016
Evaluation of delirium screening tools in geriatric medical
in-patients: A diagnostic test accuracy study
K. Hendry
1
, T. Quinn
2
, H. Miller
2
, J. Burns
2
, A.L. Cunnington
2
,
P. Fraser
2
, V. Scotichini
1
, D. Stott
3
1
University of Glasgow, Glasgow, Scotland;
2
Glasgow Royal Infirmary,
Glasgow, Scotland;
3
United Kingdom
Objectives:
It is currently unclear what clinicians should do as
a first step in the identification of delirium in older, hospitalised
in-patients.
To evaluate brief cognitive assessment tools for delirium
recommended for routine clinical practice.
Methods:
A semi-consecutive cohort of 500 non-elective, elderly-
care (
>
65 years) hospital in-patients admitted to geographically
defined beds in the geriatric medical assessment unit in an urban
teaching hospital.
Reference assessments of delirium (DSM-V criteria) and dementia
(prior diagnosis or DSM-IV criteria) were performed by 6 senior
geriatricians. Abbreviated Mental Test (AMT 10, AMT 4), 4 A’s Test
(4AT), brief Confusion Assessment Method (bCAM), months of the
year backwards and informant Single Question in Delirium (SQiD)
were conducted within 2 hrs of the reference assessment by an
independent researcher, blinded from reference assessment.
Results:
500 patients, mean age of 83 years (range = 66–101) were
assessed over 8 months. 93/500 (18.6%) of patients were diagnosed
as delirium, 104/500 (20.8%) possible delirium and 277/500 (55.4%)
no delirium. 266/500 (53.2%) were identified as definite or possible
dementia.
The brief cognitive assessments varied in sensitivity for definite
delirium from 70.3% for the bCAM (specificity 91.4%) to 92.6%
(specificity 53.7%) for the AMT-4 (score of
<
4/4). Months of the
year backwards had a sensitivity 91.3% and specificity 53.1% using
cut-point of
<
5/12 correct. The 4AT (score
<
4/12) had a sensitivity
of 81.9% and a specificity of 78.3%.
Conclusions:
Brief cognitive assessments such as the AMT-4
and months of the year backwards have good sensitivity but
low specificity as screening assessments for delirium in older
inpatients.
P-017
Early geriatric follow-up
–
a quasi-RCT
L. Holst Pedersen
Aarhus University Hospital, Aarhus V, Denmark
Objectives:
To reduce length of hospital stay and the frequency of
readmissions in elderly (+ 75 years) admitted to the emergency
medical ward without compromising the safety or the satisfaction
of the patients.
Methods:
The study was made as a quasi-RCT with a daily
randomization.
The intervention consists of a visit to the patients’ home the day
after discharge from hospital. This visit is done by a geriatrician
and a nurse. The team may provide acute hospital-at-home help if
necessary.
The intervention group is compared to a similar group discharged
from hospital without geriatric follow-up. These patients are visited
by the patients’ GP about one week later.
Results:
A total of 547 patients was included. The length of hospital
stay was 3 days shorter in the intervention group (2 vs. 5 days)
p = 0.005.
The readmission rate was also reduced in the intervention group
(13% vs. 25%) p
<
0.001.
30-days mortality was 10% in the intervention group vs. 14% in the
control group, p = 0.17.
Conclusion:
We found, that an early visit to the patients’ home
after discharge from hospital significantly reduces the length of
hospital stay and the readmission frequency.
There were no negative consequences for the safety of the patients.
A slight but insignificant reduction in 30-days mortality was
observed. The data for patient satisfaction remain to be assessed.
P-018
Multiple neoplasms including hematological malignancies
of the more than 80 years elderly
N. Kazuhiko
1
, D. Nagase
1
, S. Ishihara
1
, Y. Mitsui
1
, A. Sakai
1
,
Y. Kuraishi
1
, H. Izumi
1
1
Toho University Medical Center Hematology & Oncology, Oota-ku,
Japan
Objectives:
Progress of therapy and supporting therapy improved
a prognosis. Synchronous type patients were difficult to treat. We
reviewed synchronous type of multiple neoplasms including the
hematological malignancies of more than 80 years old.
Methods:
In the case that hematologic malignancy was diagnosed
in our hospital from 1988 to 2013, we intended for double cancer
304 cases including hematological malignancy. We reviewed 12
multiple neoplasms of synchronous type of the more than 80 years.
The examination factors are kind of the hematological malignancy,
treatment, gender, tactics of therapy.
Results:
All cases were 12 cases, but 1 case diagnosed autopsy,
so we investigated 11 cases. In 11 cases, including male 9 cases,
female 2 cases, number of malignancies, double 10 cases, triple 1
case, hematological malignancies to constitute were non-Hodgkin’s
lymphoma (NHL) 7 cases, multiple myeloma 1 case, myelodysplastic
syndrome 2 cases, macrogloblinemia 1 case, about solid cancer,
gastric cancer 3 cases, prostate carcinoma 2 cases, lung cancer 2
cases, colon cancer 2 case, pancreatic cancer 1 case, cholangioma
1 case, duodenum cancer 1 case. About therapy, chemotherapy
for cure (CTx-C)+CTx-C 1 case, CTx-C+Operation for cure (Ope-C)
6 cases, CTx-C+palliative therapy 1 case, CTx for palliative(CTx-
P)+Ope-C 1 case, best supporting care 1 case, CTx-C+observation 1
case. About cause of death, 6 death cases, hematological malignancy
5 cases, solid cancer 1 case.
Conclusions:
Even if more than 80 years old synchronous multiple
neoplasms, they have chance to survive.
P-019
Malignant lymphoma more than 80 years old cases
N. Kazuhiko
1
, S. Ishihara
1
, D. Nagase
1
, Y. Mitsui
1
, A. Sakai
1
,
Y. Kuraishi
1
, H. Izumi
1
1
Toho University Medical Center Hematology & Oncology, Oota-ku,
Japan
Objectives:
Because of aging society, the number of non-Hodgkin’s
lymphoma (NHL) patients were increasing. So we investigated NHL
of more than 80 years.
Methods:
The subjects in this study were 52 patients who were
histopathologically diagnosed as malignant lymphoma and more