S178 Poster presentations, Friday 19 September 2014 / European Geriatric Medicine 5S1 (2014) S159–S234

worse compared to others, while patients following surgery had a

relatively good prognosis.

P306

Post-discharge destination and dependence in very old patients

with acute stroke

F. Correia

Centro Hospitalar de Lisboa Norte, Portugal

Introduction: Stroke is the leading cause of chronic dependence

in the elderly. The level of dependence is an important factor

in the managing and discharge of patients with stroke. Recent

studies showed that mobilization and rehabilitation from day 1 can

significantly reduce chronic dependence. The aim of this study is to

characterize the level of dependence in patients ≥75 years old (yo)

with acute stroke and their destination after discharge.

Methods: 26-month retrospective study at a stroke unit

within an internal medicine department. Patients ≥75 yo were

analyzed. Dependence was characterized by modified Rankin scale:

absent (0–1), moderate/partial (2–3) and severe/total (4–5).

Results: 327 patients admitted, 199 (61%) ≥75 yo; median age

82yo; median length of stay 8.6 days. Before admission 114

(57.3%) were independent. At discharge: 56 (28.2%) independent,

26 (13%) moderate and 60 (30.1%) severe dependence. 139 (69.8%)

very-old patients returned home and 37 (18.6%) went to Nursing

Home or rehabilitation state-sponsored programs. Patients returned

home: 40.3% had no significant disability; 15.1% were dependent,

and 23.0% severely dependent. For Nursing home, 75.7% were

dependent and 26%with severe dependence.

Conclusion: 70%of very-old patients returned home about 1week

after acute stroke and the majority of them without significant

disability. Constraints on admission to inpatient rehabilitation

programs, leads to the returning home of patients with high

levels of dependence, overloading the family/caregivers. In 38%of

dependent patients who returned home, rehabilitation nurse

assumed a central role in developing skills to promote caregiver

training for self-care and transmission of knowledge to deal with

the patient’s limitations. It’s mandatory to invest in early in-hospital

rehabilitation by rehabilitation nurses.

Gerotechnology

P308

The effectiveness of ICT tools for sharing home healthcare

information: Which patients and healthcare professionals

would benefit most?

S. Nomoto1, M. Utsumi1, S. Sasayama1, H. Dekigai2

1Kyoto University Graduate School of Medicine, Kyoto Sakyo-Ku,

Japan; 2Dekigai Clinic, Kyoto Sakyo-Ku, Japan

Introduction: We developed the “Patient-Centered Home

Healthcare Communication System” (e-RN), which enables patients

and healthcare professionals to share information via cloud

computing. Although introducing information and communications

technology (ICT) tools to home care involves various costs, clear

rules have yet to be established with regard to their allocation to

care recipients. We investigated which home care patients would

benefit most from the use of such tools.

Methods: Patients and healthcare professionals were furnished

e-RN-installed iPads to input their health data and exchange text

messages. We divided patients into two groups according to their

levels of certified care needs, and compared the numbers of input.

Group 1 consisted of five patients (with certified support need

levels 1–2 and care need levels 1–3), and Group 2, four (with

certified care need levels 4–5).

Results: Nine patients and 18 professionals participated in the field

trial (Tables 1 and 2), conducted during September 8 to October 31,

2013. The total number of inputs for Group 2 (median: 151.5) was

significantly higher than for Group 1 (median: 93) (p < 0.05). In

addition, the total number of inputs by medical professionals for

Group 2 (median: 57) was significantly higher than for Group 1

(median: 30) (p < 0.05). As the level of patients’ nursing care

needs increased, so did the need for ICT tools among healthcare

professionals.

Conclusions: The use of ICT tools in home healthcare is suitable

for housebound patients with higher levels of care needs.

Table 1. Patient characteristics and number of inputsPatient Age Level of certified

care needs aiPad user Age of

iPad userNumber ofinputs

Number of inputsby professionals

1 92 SNL 2 Individual 92 58 402 71 CNL 1 Individual 71 65 443 86 CNL 2 Daughter 60 94 234 66 CNL 2 Individual 66 109 445 61 CNL 3 Spouse 61 112 216 89 CNL 4 Grandchild 25 177 697 76 CNL 5 Daughter 48 143 478 71 CNL 5 Spouse 70 107 419 69 CNL 5 Spouse 73 162 79

a SNL, Support need level; CNL, Care need level.

Table 2. List of professionals

Medical professional Number

Physician 2

Nurse 6

Pharmacist 4

Physical therapist 4

Nursing care manager 2

P309

Diagnosis of dehydration in elderly patients by electronic nose

analysis of exhaled air: a pilot study

C.N.W. van der Steen, M.G.M. Olde Rikkert, D. Jacobsen

Radboudumc, Nijmegen, The Netherlands

Introduction: Dehydration is a common condition in the frail

elderly, associated with adverse health outcomes, but there is no

gold standard test for dehydration. Feasible reference standards are

time consuming and minimal invasive tests. The electronic nose

is a non-invasive test using exhaled air as diagnostic indicator.

In a proof of principle pilot study, we investigated the diagnostic

potential of the e-nose for dehydration in frail elderly.

Methods: We collected 51 breath samples of hospitalized geriatric

patients. Routine clinical assessment with dedicated follow up

judgment on rehydration effects was used as validated reference

standard to diagnose dehydration. We also investigated the

practicability of the e-nose measurements for geriatric inpatients

(n = 78).

Results: Comparison between the breath samples of 35 euvolemic

and 16 dehydrated subjects resulted in a C-Statistic, sensitivity

and specificity of 0.68, 76% and 44% respectively. Intra-individual

comparison of 9 subjects in dehydrated and rehydrated condition

resulted in C-Statistic, sensitivity and specificity of 0.79, 71%, and

54% respectively. Delirium was a significant predictor (odds 4.22)

for unsuccessful performance of e-nose test application.

Conclusion: We could not prove that e-nose test analysis is a

valid test to diagnose dehydration in frail elderly, probably due to

large heterogeneity in the causes of dehydration and it’s co morbid

and underlying conditions. The test is feasible for most geriatric

patients, but not for delirious patients. Further investigation of the

diagnostic properties of the e-nose for dehydration is recommended

in more homogeneous groups.