Posters for 2026 Major Trauma in Older People

BACKGROUND Major trauma is conventionally associated with high-energy mechanisms such as road traffic collisions or falls from height. However, ground-level falls (GLFs) , defined as unintentional descents to the ground from standing height or below , are an increasingly recognised cause of serious injury and death in older adults.[1,2] Despite appearing to involve low-energy forces, GLFs frequently result in devastating injuries in elderly patients, driven by age-related physiological changes including osteoporosis, frailty, and anticoagulant use.[3,5] With the UK's older population growing

Background: Rib fractures in older adults are a marker of physiological vulnerability and are associated with complications that can extend well beyond the inpatient stay. While advanced thoracic analgesia and regional techniques are widely used to reduce pain, splinting, and respiratory deterioration, the relationship between these interventions and post-discharge outcomes is less clearly described. We evaluated 30-day post-discharge mortality in patients aged ≥65 admitted with rib fractures, comparing those who received advanced thoracic analgesia/regional intervention versus those who did

Case study of an older person with traumatic brain injury: from Greece to Glasgow, complicated by infection control protocols Introduction: The average age of major trauma (MT) patients in Scotland is now 70 years, reflecting a rising trend, with falls from standing the most common mechanism of injury (STAG Report, 2024). Older adults frequently present added complexity due to frailty and comorbidities. This case describes an older adult who sustained a traumatic brain injury abroad and, following repatriation under strict infection‑control precautions, received complex in‑reach MT

Introduction Older adults form an increasing proportion of trauma admissions, with low-level falls accounting for most injuries. Ageing is associated with reduced physiological reserve, multimorbidity, and greater vulnerability, leading to higher mortality even after low-energy trauma. As geriatric trauma increases, there is increasing emphasis on frailty assessment, prognostication, and advance care planning to support appropriate, patient-centred decisions. This study aimed to identify which injury patterns contribute to increased mortality in the local geriatric trauma population and

Introduction Significant injuries are often missed in patients over 65. This may reflect the perception that low-energy mechanisms are unlikely to cause injury, distracting injuries, communication barriers, or a combination of factors. Delayed fracture diagnosis adversely impacts patient outcomes. A silver trauma screening tool was developed in line with new trust guidance. It recommends that all patients aged over 65 with a Rockwood Clinical Frailty Scale score >5 presenting following a fall undergo trauma screening on admission. The tool consists of shake (cervical spine fractures), rattle

Aim: Optimising the management of older patients admitted with intracranial haemorrhage (ICH) to a District General Hospital. Methodology: This retrospective quality improvement project included patients >65 years old admitted with ICH under the general surgical team over a six-month period (01/01/2025-01/07/2025). Data was collected from the electronic health record (Cerner) and outcomes were analysed. Data will be presented as median (range) unless stated otherwise. Statistical analysis conducted on GraphPad Prism. Results: 62 patients were included, aged 84 (65-99) years. Thirty-three

Introduction: Optimising the management of older patients with rib fractures at a District General Hospital. Method: This retrospective quality improvement project included all patients >65 years old admitted with rib fractures over a six-month period (01/01/2025–01/07/2025). Data was collected from the electronic health record (Cerner). Data will be presented as median (range). Statistical analysis conducted on GraphPad Prism. Results: 81 patients were included, aged 82 (65-100) years. Fifty patients (61%) had a clinical frailty score (CFS) The average battle score was 23, with twenty-seven

Background: Geriatric trauma admissions continue to rise, yet optimal care pathways for this population remain poorly defined. Although trauma centre care improves outcomes in the general trauma population and palliative care is known to support patients with complex needs, their combined value in geriatric trauma remains unclear. At The Hillingdon Hospitals (THH), we observed that older trauma patients frequently lacked timely recognition of dying, received delayed or absent ceilings of care, and often underwent prolonged active treatment despite frailty, comorbidities, or prior care

Background: Delirium is a frequent and serious complication in older trauma patients, affecting an estimated 20–60%, particularly after fractures, spinal injuries, and prolonged immobilization. It typically arises from a combination of factors, including the acute effects of injury, pain, polypharmacy, infection, constipation, urinary retention, and physiological stress layered onto existing comorbidities and reduced cognitive reserve. Despite its impact, delirium is often under-recognised in busy ward settings, where hypoactive presentations are easily mistaken for fatigue, low mood, or

Introduction  Delirium is a common but serious complication in older surgical patients, associated with increased morbidity and mortality, prolonged length of stay and poorer long-term outcomes. NICE guidance recommends all patients are observed daily for signs of delirium and promotes a multidisciplinary approach to prevention and management. The diagnosis and documentation of delirium is important for coding, handover of care and for helping patients and families understand their symptoms.  Methods  Clinical notes of patients aged ≥65 discharged from general surgery in January 2025 (n = 38)

Introduction: Dysphagia is common in older people and is associated with aspiration and respiratory complications, particularly in those with cervical spine fractures1. A pilot study (2021) led to standards of care (SOP), developed with SLT team, for staff training to initiate early bedside dysphagia screening to mitigate respiratory complications and improve outcomes. Aim: To evaluate whether bedside dysphagia screening in older patients admitted with cervical spine fractures can mitigate aspiration and respiratory complications. Method: A retrospective cohort study using electronic records

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

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

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 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 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: 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