Posters

With an ageing population, the number of older people attending emergency departments with head injuries is increasing. 2023 NICE guidelines advise to consider a CT scan for these patients who have sustained a head injury and have no other indication for a CT head scan but are on anticoagulation treatment or antiplatelet treatment. However, there are time, financial and personal costs of hospital conveyance to facilitate scanning to both individuals and the wider system. Method Across two UK, South coast hospitals, retrospective review of requests for CT brains from 1964 patients over 80years

Background Skull base osteomyelitis (SBO) is an uncommon but life-threatening complication of necrotising otitis externa, typically affecting older adults with diabetes. Presentation is often non-specific, and diagnosis is frequently delayed. Case An 84-year-old man with type 1 diabetes, vascular comorbidity and advanced frailty presented with a fall preceded by dizziness on standing. He reported a 6-month history of recurrent falls and severe postural light-headedness. For 3 months, he had persistent right-sided otalgia and offensive otorrhoea treated in primary care with repeated courses of

St Mary’s is a central MTC and receives approximately 340 ‘Major Trauma Calls’ per month. Rib fractures (RF) are often seen in major trauma, frequently feature in high-acuity mechanisms of injury, and are known to cause extensive pain and distress. St Mary’s RF SOP directs trauma teams to utilise a 24/7 ‘invasive’ analgesic pathway (advance regional nerve blocks/epidurals/PCA’s) as part of a multimodal analgesic approach to acute pain. The RF SOP defines invasive pathways indicated if a patient’s rib fracture severity score ‘STUMBL’ is >16. Our team completed a retrospective cohort data

Introduction: Sleep disturbances are common in individuals living with dementia, especially those living with Lewy Body Dementia (LBD) and Parkinson’s Disease (PD). These disturbances are associated with increased depressive symptoms among carers and can precipitate transition to care homes. DREAMS:START (Dementia RElAted Manual for Sleep; STrAtegies for RelaTives) is a clinically effective intervention for sleep disturbance in all-cause dementias. However, the experiences of supporting individuals living with LBD or PD and sleep disturbance remains unexplored. Therefore, this study sought to

Aim: To create a clinical culture of “Think Trauma” with all 65+yr olds presenting following unplanned attendances to the ground from any height for any reason. A good trauma assessment should be possible regardless of the first contact clinicians admitting specialty or grade. Overall improving initial assessment, management of and reduction in missed injuries in these older trauma patients. Method: Formed a senior multispecialty team to identify an educational plan. Based on narrative feedback from other trauma courses, a low-fidelity simulation-led course was created. Aimed at more junior

Introduction The Oxford and Reading Cognitive Health After Recovery from acute illness and Delirium- Prospective Study (ORCHARD-PS) aims to investigate the pathophysiology of delirium and future dementia risk after acute illness (Gan JM, Elderton L, Vijayakumar Sheela M, et al. BMJ Open, 2025 Jun 13;15(6):e102028). We determined baseline delirium occurrence, delirium subtype and associations with cognition and frailty in an interim analysis. Methods Acute medical patients aged 65 years and older without terminal illness, advanced dementia or nursing home residence were enrolled after consent

Introduction Falls are a leading cause of hospital admission in the elderly frail population. Current NICE guidance specifically recommends CT imaging as primary investigation of choice for detecting a clinically important brain injury (CIBI) in patients over age 65, with LOC/amnesia, or on anticoagulation who have sustained a head injury (HI). Aim To consider appropriateness of NICE guidance for CT head imaging for patients living with frailty, who present with HI following a fall from standing height. Method Clinical audit of 329 patients, Clinical Frailty Score 4-8, presenting with HI

Introduction Injurious falls are common, especially amongst adults older than 65. World and UK guidance recommend adopting a multifactorial approach to falls prevention, and there are tools that can support practitioners to address multiple falls risks. Many of these risks can be addressed through simple, practical actions (e.g., removing trip hazards, checking suitability of footwear). Social prescribing practitioners (SPPs) provide patients with non-clinical practical and emotional support in the community and are well-positioned to prevent falls. To our knowledge, no effective, evidence

Introduction There are numerous risk factors for falling in older adults, and world and UK guidance advocate adopting a multifactorial approach to falls prevention. Many falls risks can be addressed through actions for which clinical training is not required (e.g., removing trip hazards or providing advice about footwear). Patients’ access to falls prevention could be improved by supporting non-clinicians to use a standardised approach to identify risks and preventative actions. We aimed to identify risks and actions described in the published literature that could be incorporated into a novel

Introduction Older patients are at a higher risk of suffering injuries that are classed as major trauma (MT), due to a variety of factors. Injuries to the orofacial region present unique challenges in their management, necessitating a balance between functional and aesthetic demands. Despite these challenges, few studies to date have considered how a facial injury may impact outcomes in the older population. We describe a 10-year review at a major trauma centre (MTC) of older patients, who present with facial injuries alongside MT. Methods Data for patients over 65 years old who attended our

Introduction Atypical parkinsonian syndromes (APS), progressive supranuclear palsy (PSP), multiple system atrophy (MSA) and corticobasal degeneration syndrome (CBS), are relatively rare and clinically heterogeneous. This can result in misdiagnosis, usually for idiopathic Parkinson’s disease. Recent cohort studies indicate characterising NPS could facilitate earlier and more accurate APS diagnosis. We audited NPS and associated management in a specialist APS clinic population. Methods Electronic patient records were reviewed for 97 ‘active’ patients attending the Oxford University Hospitals APS

Introduction Inpatient falls among older adults living with dementia are a significant patient safety challenge in acute hospital settings. Disorientation in unfamiliar environments and variable staff confidence in mobilisation contribute to avoidable harm, distress, and increased healthcare costs. This quality improvement project aimed to test the feasibility and early impact of a dementia-friendly environmental and training intervention on an acute elderly care ward. Method A quality improvement pilot was conducted on Hardy Ward, an acute elderly care ward within a large NHS Trust. Using a

Introduction: The 2023 National Institute for Health and Care Excellence (NICE) guidelines advocate consideration of a Computer Tomography (CT) scan in people taking anticoagulants with sustained head injury regardless of other risk factors. In practice, this is typically implemented as a mandatory indication for imaging. We reviewed ED attendances of those aged over 65 on anticoagulation who underwent a CT following head injury, to identify factors that could indicate a higher or lower risk of radiological evidence of acute traumatic brain injury (TBI). Methods: ED attendances between July

Introduction Subaxial cervical spine fractures in older adults are increasingly common and often occur in the context of frailty, multimorbidity, and low-energy trauma. Despite this, outcome data to guide optimal management are limited. We aimed to describe early morbidity and mortality and identify factors associated with poor outcomes in older patients with these injuries. Method We conducted a retrospective cohort study of consecutive patients aged 65 years and over admitted to our Major Trauma Centre with subaxial cervical spine fractures. Data collected included demographics, pre-injury

Introduction Early geriatrician involvement in trauma care supports comprehensive geriatric assessment (CGA) and improves outcomes. National workforce constraints mean this specialist input must be targeted to patients most likely to benefit. We undertook a mixed methods service evaluation of a geriatric medicine in-reach service at a major trauma centre to map clinical activity and obtain multidisciplinary (MDT) feedback. Methods We undertook a retrospective mixed methods evaluation of all patients reviewed by the geriatric in-reach team between March and June 2025. Cases were identified from

Introduction: People aged over 65 who take anticoagulants commonly present to the Emergency Department (ED) for assessment following a head injury. It is well documented that prolonged ED stays are associated with increased complications and morbidity particularly in older people with frailty. This audit aims to quantify the experience of people undergoing assessment in ED following a head injury. Methods: This retrospective audit reviewed people presenting to EDs over a 3-month period. People included were aged 65+, taking anticoagulants, who underwent a CT scan for head injury. Data

Introduction Clock Drawing Tests (CDTs) are an integral part of Comprehensive Geriatric Assessments (CGAs). It is a brief, validated screening tool that assesses multiple cognitive domains. Studies have shown CDT performance is valuable in identifying early cognitive impairment, later functional decline and need for higher levels of care. Our quality improvement project (QIP) focused on evaluating the use of CDTs within CGAs completed by the Geriatric team at Royal Gwent Hospital (RGH). By identifying if CDTs are being used and the barriers to their application, we can implement strategies to

Introduction In our hospital, management of spinal fractures in older adults are led by external neurosurgical services. Decisions often prioritise imaging characteristics over patient characteristics. Challenges include conducting low-yield imaging such as MRIs, prolonged immobilisation, delayed decision-making reliant on digital communication and bracing complications. This audit evaluated whether collaborative, patient-centred decision-making between geriatricians, orthopaedics and therapists who are familiar with the spinal pathway improved length of stay and resource utilisation. Methods

Introduction: Antipsychotics in dementia are associated with higher risks of a wide range of serious health outcomes. Bradford is a national outlier in antipsychotic prescribing with 14.9% of dementia patients prescribed antipsychotics in March 2024 compared to 9% across England. Understanding and addressing the overuse of antipsychotics in BPSD is a priority for the Trust and the West Yorkshire Integrated Care Board (WYICB). Method: This 12-month quantitative service development project involved 78 care homes across Bradford District and Craven. Residents meeting deprescribing criteria were

Introduction: Many antipsychotics contribute to anticholinergic side effects, including confusion, cognitive decline, and increased dementia risk. Reducing antipsychotics in behavioural and psychological symptoms of dementia (BPSD) may lower these risks and is a priority in Bradford District and Craven. Method: Care home residents taking antipsychotics for BPSD were identified by a mental health nurse in conjunction with care home staff in a larger yearlong deprescribing project. Appropriate residents were enrolled into a deprescribing protocol. The deprescribing regime was communicated to