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S64
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
patients should be based on periodic assessment, by conducting
annual spirometry.
– COPD patients smokers should quit smoking.
– COPD patients who are smokers should receive anti-smoking
advice.
Results:
Compliance criteria (by year):
– COPD prevalence, 5.04%/504%,
– COPD annual spirometry, 59%/60%.
– anti-tobacco interventions, 54%/57%.
– active smokers, 45%/58%.
Conclusions:
The uptake of COPD patients is well below the
expected prevalence (10.3%). The COPD prevalence in men
4.12%/4.13%, and COPD prevalence in women 0.92%/0.91%, lower
than those of the community, which are 15% and 5.5% respectively.
This represents an underdiagnosis of 76.61%. Results largely in line
with IBERPOC Study (COPD prevalence in Spain, 1997) and the EPI-
SCAN study (COPD prevalence in people 40 to 80 years in Spain,
2007) in which Underdiagnosis record of 78% and 73% respectively.
There is a large group of patients with normal spirometry in which
we should review the adequacy of diagnosis.
The percentage of current smokers COPD is very high.
The frequency of smoking in our COPD is maintained.
Improving care for COPD should focus on the recruitment,
especially considering women smokers, and improved diagnostics
by conducting annual spirometry and active smoking intervention
and individualized.
P-119
Neuropathic pain questionnaire in diabetic elderly patients
A. Kilavuz
1
, F. Sarac
1
, S. Savas
2
, F. Akcicek
1
1
Ege University Medical Faculty, Izmir, Turkey;
2
Ege University
Medical Faculty, Internal Medicine Department, Geriatrics Section,
Izmir, Turkey
Objective:
Degree and duration of hyperglycemia is a risk factor
for the development of neuropathy. We aimed to determine
the relationship between diabetic neuropathic pain (NP) and
HbA1c, fasting blood glucose (FBG), postprandial glucose (PPG),
vitamin B12, serum lipid profile on diabetic patients over 50 years
of age.
Methods:
Participants ≥50 years old were taken into the study
from Ege University Internal Medicine Clinic. The participants
were evaluated for sociodemographic data, biochemical results.
Neuropathic pain diagnostic questionnaire (DN4) were applied to
patient. According to questionaire, ifscore is ≥4, there is very high
probability of NP. Data were evaluated using analysis of SPSS 21.0
software package.
Results:
58 diabetic patients were included into our study.
Mean age was (62
±
8)(range, 50–96) years; 67% were women,
median diabetes duration was 9 (4–22) years. Diabetic NP score
was
<
4 in 36 patients (62.1%) and ≥4 in 22 patients (37.9%).
FBG, PPG and HbA1c values were higher in patients with
high probability of diabetic NP. But this was not statistically
significant (p = 0.214, p = 0.295, p = 0.315, respectively). There was
no significant relationship between the probability of diabetic NP
with triglycerides and LDL-cholesterol levels. Probability of diabetic
NP was higher in patients with low vitamin B12 levels. But this was
not statistically significant. (p = 0.609).
Conclusions:
Fasting blood glucose, postprandial blood glucose and
HbA1c levels were higher and vitamin B12 levels were lower in
patients with high probability of diabetic neuropathic pain. Larger
studies are needed in this area confirming the diagnosis with
objective methods.
P-120
Postprandial hypotension among patients from an acute
geriatric ward: results from a pilot study
E. Boland
1
, G. Brackelaire
1
, Y. Anani
1
, C. Lutss
1
, G. Cremer
1
,
M. De Saint-Hubert
2
, D. Schoevaerdts
3
1
CHU Dinant-Godinne UCL Namur, Yvoir, Belgium;
2
UCLouvain, Yvoir,
Belgium;
3
CHU Dinant-Godinne UCL Namur, Floreffe, Belgium
Objectives:
To determine the prevalence of postprandial
hypotension (PPH) and risk factors among patients admitted to
a geriatric ward.
Methods:
During a 2 months period, after informed consent, 56
patients were prospectively enrolled and tested for PPH using a
standardized protocol. PPH was defined as a drop in systolic blood
pressure (SBP) of more than 20mmHg or a drop below 90mmHg
(if preprandial SBP was above 100mmHg) within the following
90 minutes of a dinner of more than 400 kccal.
Results:
Overall, 42% (n = 41/97) patients were excluded from the
study. The prevalence of PPH was 52% (95% CI: 38–65%; n = 29/56),
while a symptomatic PPH was less frequently reported (23%; 95% CI:
13–36%). No differences (P
>
0.10) were observed between the two
groups (PPH+ and PPH−) for age, sex, BMI, MNA-SF, Charlson
Comorbidity Index, diabetes, concomitant orthostatic hypotension
and grip-strength. The following risk factors tended to be associated
with PPH: nursing home residents (OR: 4.8; P: 0.064), antiarrhyth-
mic drugs (OR: 1.6; P: 0.103) and a timed get-up and go test below
20 s (OR: 2.6; P: 0.083). Consumption of more than 1 hypotensive
drugs (OR: 3.8; P: 0.019) and a good level of ADL score (OR: 6.9;
P: 0.002) were strongly associated with the occurrence of PPH.
Conclusion:
This pilot study confirms that PPH is prevalent in
an elderly hospitalized population but symptomatic PPH is less
frequently observed. Beside the small sample size leading to a
type II error risk, we confirm that consumption of
>
1 hypotensive
drug is a strong risk factor.
P-121
Readmission rates is not related to physical condition or
comorbidity but maybe to the amount of patients admitted
M. Schultz
1
, L. Usinger
2
1
Herlev Hospital, Herlev, Denmark;
2
Medical Department Herlev
Hospital, Herlev, Denmark
Objectives:
Readmissions are a major problem in healthcare, as it
is associated with increased morbidity, mortality and expenses.
In our department we found a disturbing rising number of
readmissions over a two-year period. In the period with rising
number of readmissions, we had more patients admitted to the
ward. Our hypothesis was that the increased readmission rate
could be explained by a patient group with more comorbidities and
poorer physical condition, simultaneously with decreasing length
of stay. The purpose of the study was to identify factors influencing
readmission rate, modifiable for future interventions.
Methods:
All patients discharged from geriatric unit were included.
We collected data from the Danish Geriatric Database. Patients
readmitted of all courses within 30 days were identified and their
medical records were retrospectively assessed. Physical condition
was assessed using Barthel Index.
Results:
We found no significant difference between the readmitted
and the not-readmitted patients with regard to length of stay,
Barthel, comorbidity or whether they were discharged to home
or an institution. Monthly readmission rates showed a 6 months
period in 2013 with significantly lower readmission rates (9% vs.
18%, p = 0.025). In this period we had less patients admitted. Overall
readmission rate in 2013+2014 were median 17%.
Conclusions:
We could not find data to support our hypothesis, but
in periods without excess number of patients we managed to half
the readmission rate. Overall we kept low rates compared to local
and international data, most likely, because we have implemented
several interventions at discharge to reduce readmissions.