Poster presentations, Friday 19 September 2014 / European Geriatric Medicine 5S1 (2014) S159–S234 S207

We used multiple logistic regression analysis of baseline frailty

indicators and risk factors for delirium. Secondly, we examined

prevalent and incident delirium in included and excluded patients.

Results: Excluded patients (n = 77) were older, were more frail,

had more risk factors for delirium and frailty, and more often

had delirium at admission than the included group (n =115).

Independent predictors for exclusion were lowMMSE, high IQCODE,

poor vision and polypharmacy.

Conclusion: This is one of few studies testing different risk factors

for excluding elderly patients from an RCT. Inability to give informed

consent was an a priori risk factor, but also other frailty indicators

independently raised the risk of exclusion. Findings suggest that

taurine was tested in a group of patients that may not be

representative of the geriatric hospital population.

P399

Decrease in the number of Accidents and Emergencies

unit (A&E) visits by the nursing home population after the

introduction of domiciliary care

M. Mozos

Mutuam, Spain

Introduction: The urgent medical attention to geriatric population

in nursing homes has been historically delivered in the A&E unit

of the Central Regional Hospital (CRH). Since May 2013, we have

introduced a new system of advanced domiciliary care for nursing

homes from 8am to 8pm, formed of a physician and a nurse. We

analyse the impact of this service on the number of visits to the

A&E unit.

Methods: We analysed the data available from May 2012 to

February 2013 and compared it to the data available from May

2013 to February 2014. We analysed the number of elderly people

who attended A&E unit, the date and time of arrival, and discharge.

The data was provided by the CRH.

Results: In the period from May 2012 to February 2013, the number

of residents visiting the A&E unit were 1450 (Monthly average: 145;

SD: 9.18). Since the introduction of advanced domiciliary care, in

May 2013, the number of residents attended was 1246 (monthly

average: 124.6; SD: 11.1).

The number of residents who visited A&E unit decreased by 16.10%

(p < 0.001), a reduction of 203 visits, compared to the period from

May 2012 to February 2013.

Conclusions: Advanced domiciliary care decreases the number of

patients visiting the A&E unit. Our results are preliminary, since the

new system is in its initial phase. The effectiveness of the advanced

domiciliary care should be reevaluated to confirm these promising

results.

P400

Trends in in-hospital mortality and 30-day post-discharge

mortality in acutely admitted older patients between 2000

and 2009 in the Netherlands

M. van Rijn, B.M. Buurman, J.L. Macneil-Vroomen, E.P. Moll van

Charante, S.E. de Rooij

Academic Medical Center, Amsterdam, The Netherlands

Introduction: Acutely hospitalized patients show high rates of in-

hospital mortality and 30-day post-discharge mortality. Over the

past 10 years, in-hospital mortality has decreased for most diseases.

However, it is unknown whether in-hospital mortality and 30-

day post-discharge mortality, in acutely hospitalized older patients

decreased. Therefore, the aim of this study is to investigate trends

in in-hospital mortality and 30-day post-discharge mortality for the

six most prevalent acute diagnoses in patients 65 years and older.

Methods: Retrospective data analyses were conducted for 263,746

patients aged 65 years and older who where acutely admitted

for myocardial infarction (MI), heart failure (HF), stroke, chronic

obstructive pulmonary disease (COPD), pneumonia and femur

fracture (according to the International Classification of Diseases,

ninth revision) between 2000 and 2009. Multinomial regression

analyses were performed with 2000 as a reference year. Results

were adjusted for sex, age, cultural background, living situation

before admission and length of hospital stay.

Results: The risk of dying 30-day post-discharge relative to dying

in hospital increased in 2009 compared to 2000, especially for

stroke (OR4.02;CI 3.51–4.61) and MI (OR2.25;CI1.89–2.68). Smallest

OR was found for COPD (OR 1.68; CI 1.39–2.04). The risk of survival

relative to dying in hospital increased in 2009 compared to 2000,

which indicates a decreased risk of dying in hospital versus survival

(stroke: OR2.94;CI2.76–3.13 and MI: OR 3.08; CI 2.81–3.38).

Conclusion: This study shows an increased 30-day post-discharge

mortality between 2000 and 2009, while in-hospital mortality

declined. Therefore there is a need for interventions decreasing

post-discharge mortality.

P401

Do your patients know who you are?

F. Ehsanullah, R.L. Chu, J.T. Healy, D. Morganstein

Chelsea and Westminster Hospital, London, United Kingdom

Introduction: The GMC’s Good Medical Practice states that doctors

must ensure that all patients “understand [the doctor’s] role and

responsibilities in the team, and who is responsible for each aspect

of patient care”. We assessed what proportion of medical patients

knew the name of their consultant, junior doctor and ward.

Methods: All inpatients on general medical wards were surveyed

over a week in a busy teaching hospital. Patients had undergone at

least one consultant ward round. Exclusion criteria were: elective

admissions, patients with an Abbreviated Mental Test Score below

7 and patients on the Acute Assessment Unit due to brevity of

stay and transferring of care between doctors. Medical notes were

reviewed to identify which doctors were caring for each patient.

Results: Of a total of 88 inpatients identified, 46 met inclusion

criteria. The mean age of patients surveyed was 74. 43% (n =20)

knew their consultant’s name, 15% (n =7) knew the name of any

of their junior doctors, and 41% (n =19) knew their ward. Patients

under 65 years were more likely to know their consultants name

compared with those over 65 years (73% vs 34%, p =0.037).

Conclusions: Our study highlighted a striking lack of knowledge

amongst patients regarding who their doctors were and their

hospital location. Interestingly, older patients were less likely

to know their consultant’s name which may contribute to

disorientation when in hospital. We recommend that patients are

given this information in a written form upon admission. This could

improve accountability and also consolidate the doctor-patient

relationship.

P402

Readmissions after discharge from an acute geriatric unit;

an analysis of probable causes

A.H. Ranhoff, S. Alaburic, T. Engstad, L.K. Mensen, T. Svendsen

Diakonhjemmet Hospital, Oslo, Norway

Background: Readmissions after acute hospitalization in medical

departments are frequent and often used as a quality indicator.

Geriatric patients are at high risk for readmissions.

The aim was to find characteristics of patients who had been

readmitted after discharge from an acute geriatric ward. In 2012

the Coordination reform was implemented with intention to earlier

discharge from hospital to primary care.

Material and Methods: A retrospective observation study, using

patient administrative data and medical record information from

January-June in 2011 and 2013. Data about admissions and within-

30-days readmissions including primary diagnoses were obtained.

Results: In January-June 2011, length of stay (LOS) was 8.2 days

(mean), median 5.3, and 46 of 448 (10.2%) patients were readmitted.