Posters for 2026 Major Trauma in Older People

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

Background Silver trauma is an increasingly common presentation within the Emergency Department (ED) especially in rural locations with an ageing population. Such patients often present with lower mechanisms of injury leading to under recognition of significant trauma and injuries in ED, and therefore inappropriate admission to medical wards. Aim To examine silver trauma patients presenting to a district general ED and determine whether injuries are under recognised on initial assessment. A silver trauma bundle was proposed to aid recognition and management of these patients in ED. Methods

Introduction: This process mapping compared the ED journey of patients aged ≥65 years with those <65 years presenting to the Royal Sussex County Hospital (RSCH), the Major Trauma Centre for Sussex. Methods: We conducted a retrospective snapshot audit of adult trauma patients (stratified into ≥65 and <65 year groups) presenting to RSCH ED September–October 2025. Eligible cases were identified via the local Trauma Database (Panda). Comparative statistical analysis was performed using Welch’s ANOVA. Results: Ninety patients were included (45 aged over 65 years; 45 aged under 65 years). Older

Method Patients aged over 65 with moderate (Injury Severity Score ISS > 9) or major trauma (Injury Severity Score ISS >15) admitted to Aberdeen Royal Infirmary, NHS Grampian, had a Clinical Frailty Score (CFS) recorded within their rehabilitation documentation. Scores were assigned by trauma coordinators, Emergency Department clinicians, or the Frailty Team. Data were collated in an MTC patient spreadsheet, and entries from 2025 were extracted and analysed. Results Initial analysis showed 213 patients were on North of Scotland MTC pathway over the 12 month period, 82 were over 65 years old

Introduction Data from the Trauma Audit & Research Network (TARN) show that older adults now represent the majority of trauma admissions with frailty associated with an increased 30-day mortality. TARN highlights inequalities in care for patients aged >60 years, including delayed surgery and reduced senior input. This quality improvement project assessed whether older trauma patients receive a structured and thorough Emergency Department (ED) assessment in line with the HECTOR pro forma. Method A retrospective review of patients aged >65 years (n=50) presenting to Huddersfield Royal Infirmary

Background Older adults admitted under General Surgery, particularly with head injury or rib fractures, commonly live with frailty and complex needs. Early Care of the Elderly (COTE) involvement enables comprehensive geriatric assessment and reduces avoidable harm, yet referrals are inconsistent and poorly targeted. Aim To assess and improve (1) referral of older general surgical inpatients who met locally agreed COTE criteria, and (2) alignment of referrals with those criteria. Methods Two retrospective audit cycles of General Surgery admissions aged ≥65 years at Tunbridge Wells Hospital were

Complications arising from head injuries obtained during falls, particularly intracranial bleeds (ICBs), are a major cause of morbidity and mortality in older people. For older adults, the most common mechanism of injury leading to ICBs is falling, and up to 43% of those hospitalised for these fall-related bleeds iexperience long-term disability. This audit set out to determine the effect of adherence to local and national guidelines for older people with fall-related ICBs. We analysed clinical data pertaining to 84 people over the age of 65 (82.8 +- 8.50, 59.5% female) receiving care in the

Background Data were collected in the older adults with neck of femur and distal femur fractures on Orthogeriatric wards, Leeds General Infirmary. Introduction Older adults undergoing surgery are particularly vulnerable to opioid-related harm due to age-related changes in pharmacokinetics, multiple morbidity, frailty, and poly pharmacy. Variation and inconsistency of peri-operative opioid relating to dose selection, complications and duration were identified resulting potentially avoidable complications including delirium, constipation, prolonged recovery times. Data from the first cycle

Introduction The incidence of traumatic brain injury (TBI) in older adults requiring admission to the intensive care unit (ICU) is increasing. Early ICU mobilisation is recommended, however, the effect of age on mobilisation practices after TBI remains poorly understood. This service evaluation aimed to describe ICU mobilisation activity and outcomes by age in patients with TBI. Methods A single-centre retrospective service evaluation was conducted, including all adults admitted to the ICU with TBI between January 2022 and November 2024 (CARMS ID-22399). Demographics, ICU admission

Introduction: HECTOR is a 2 day SIM based course that originated in Birmingham, and is designed to train healthcare professionals to deliver patient centred care for older people who have sustained traumatic injuries. Our goal was to develop "HECTOR Scotland" (an adapted course to fit Scottish guidelines) to allow those across the major trauma networks in Scotland to access the course, and to grow a Scotland based multi-disciplinary faculty. Method: The first HECTOR Scotland was delivered in March 2023, with an initial faculty of six (5 doctors and 1 nurse). Since then, 7 further courses have

Introduction Older people are at increased risk of significant injury following low-energy trauma and may present without physiological compromise. This can lead to under-recognition of injury and delayed management. The Norfolk and Norwich University Hospital (NNUH) Emergency Department uses an adopted Silver Trauma triage tool incorporating multiple clinical risk factors to guide senior review and CT polytrauma imaging. However, the predictive value of individual risk factors within this tool remains uncertain. This project aimed to evaluate the performance of individual risk factors in

Introduction Older adults admitted with femoral fragility fractures require coordinated multidisciplinary team (MDT) approach. On a 33-bed orthopaedic trauma ward with predominantly older people with frailty, MDT identified systemic challenges causing prolonged length of stay and suboptimal patient experience. Key issues included fragmented MDT processes, duplication between board rounds and ward reviews, delays in investigations and decision-making, inconsistent communication with patients and families, and frequent outlying of patients to other wards. Although national guidance emphasises

Introduction Rib fractures in older adults are associated with significant morbidity and mortality, mainly due to inadequate pain control and subsequent respiratory complications. Baseline audit demonstrated fragmented care, with admission across multiple specialties and wards and delayed access to specialist input and analgesia. Aims To improve pain management, coordination of care and clinical outcomes for older adults with rib fractures through the implementation of a multidisciplinary care pathway. Methods A multidisciplinary pathway was developed involving emergency medicine, radiology

Introduction Frailty is increasingly recognised as a stronger predictor of adverse outcomes following major trauma than chronological age alone. The Nottingham Trauma Frailty Index (NTFI) conceptualises frailty as a multidimensional construct incorporating functional dependence, cognitive impairment, and physiological vulnerability. However, several original NTFI variables are not routinely available at emergency department (ED) presentation. We aimed to develop and evaluate a proxy-based adaptation of the NTFI using routinely collected trauma registry data in Saudi Arabia. Methods We analysed

Introduction: The Care of the Elderly/Frailty team at UHCW sought to improve practice in the application of the Recommended Summary Plan for Emergency Care and Treatment plan (ReSPECT A rapid review of the evidence was undertaken, focusing on a broad review question: what are the educational needs of healthcare professionals regarding the optimal communication and understanding of ReSPECT needs with patients and other healthcare colleagues? Methods: A multi-professional Critically Appraised Topic group (CAT) with 6 clinicians from the frailty team at UHCW was established engaging appropriate

Introduction The Battle score is a validated risk stratification model for traumatic rib fracture presentations to secondary care. When combined with the Clinical Frailty Score (CFS), it aids identification of older patients living with frailty with increased risk of rib fracture complications. Multimodal analgesia is central to rib fracture management. NICE guidance states Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) should not be prescribed for these patients. The audit aimed to determine whether Rib Fracture Risk Stratification Scores (RFRSS) were used, if appropriate analgesia was