Posters for 2026 Wales Autumn Meeting

Introduction Falls and frailty are major causes of morbidity and loss of independence in older adults, with low lower-limb muscle mass contributing to both. Although calf circumference (CC) is established as a simple anthropometric marker of muscle mass, the potential value of thigh circumference (TC) is less well defined. We reviewed evidence examining TC in relation to falls, frailty and associated functional outcomes. Method A focused scoping search of literature identified studies assessing TC or thigh muscle thickness in older adults in relation to falls and frailty. Thirteen studies

Introduction Chronic rhinosinusitis with nasal polyps (CRSwNP) is ranked as the sixth most common chronic condition in older patients. The European Position Paper on Rhinosinusitis and Nasal Polyps estimates CRSwNP prevalence at 5% in adults aged ≥60, versus 1–4% in the general adult population. Current conservative treatments primarily reduce symptoms and dampen inflammation rather than substantially manage the underlying pathology. Surgery for CRSwNP has a considerable post-operative recurrence rate, ranging from 12–51%. Despite the clear epidemiological preponderance in older adults, this

Introduction Over 340 virtual hospital (VH) programs now operate across England, with a 60% increase between May 2022 and January 2023. Complex bone and joint infections (CBJIs) account for roughly 15% of Emergency Department caseload and disproportionately affect older adults, who face heightened risks from prolonged hospitalisation. Inpatient costs average £345/day. The Royal Berkshire Hospital established its Virtual Hospital in 2022 to provide outpatient monitoring and ambulatory treatment for CBJI patients. Given the paucity of data in this population, this study characterises

Background: Frailty, multimorbidity and polypharmacy are associated with poorer postoperative outcomes, increased complications and loss of functional independence. National guidance recommends early frailty identification and comprehensive geriatric assessment (CGA) within surgical pathways to facilitate optimisation and informed decision-making (1). A novel digital frailty self-screening pathway was introduced across elective surgical services within Swansea Bay University Health Board, enabling patients to identify potential frailty-related concerns and trigger referral to the existing

Influenza A Pneumonia Unmasking Platypnoea–Orthodeoxia Syndrome Secondary to Patent Foramen Ovale Background: Platypnoea–orthodeoxia syndrome (POS) is a rare condition characterised by dyspnoea and arterial desaturation in the upright position with improvement when supine. It results from right-to-left shunting and may arise from intracardiac causes, most commonly patent foramen ovale (PFO), or extracardiac mechanisms including pulmonary arteriovenous malformations, hepatopulmonary syndrome, parenchymal lung disease, and thoracic structural abnormalities. A precipitating factor is often

Introduction Delirium is common among older adults admitted to hospital and is associated with adverse outcomes. However, the magnitude of its association with in-hospital mortality and whether this differs between ward and intensive care unit (ICU) settings remain uncertain. This systematic review and meta-analysis evaluated the association between delirium present on admission and mortality. Methods Observational studies comparing outcomes in hospitalised older adults with and without delirium on admission were included. Meta-analysis was performed in R using the meta and metafor packages

Introduction: Frailty is increasingly encountered in clinical practice, yet undergraduate opportunities to develop confidence in managing older adults with frailty remain limited. We developed and evaluated a simulation-based teaching session aiming to enhance Swansea University medical students’ confidence in assessing and managing common frailty presentations. Methods: A frailty simulation teaching session was delivered to Year 3 Graduate Entry Medicine students during their frailty specialty attachment clinical placement. The sessions were delivered across two clinical sites, with each site

Introduction: The 2025 the Pembrokeshire inpatient census showed 75% of over 65-year-old inpatients have a Rockwood Clinical Frailty Score (RCF) ³>/=5, and 90% have one >/=4, highlighting a significant prevalence of frailty within this area. The Comprehensive Geriatric Assessment (GCA) is an evidence based aspiring practice for treating patients living with frailty. The Withybush Frailty Pathway model implements early identification of frailty, access to the MDT and continuity of consultant care retained throughout hospital stay. Methods: Patients presenting to Withybush Hospital with a RCF >/

Abstract Content : Introduction Falls in the elderly over the age of 65 are common, and the prevalence increases with age. Current NICE guidance on managing falls involving head injury in patients receiving anticoagulation can be challenging to interpret. Combined with increasing pressures on ambulance services and emergency departments (EDs), this prompted development of a collaborative admission avoidance pathway. Methods A joint head injury pathway was developed by the Royal Berkshire NHS Foundation Trust (acute hospital), Berkshire Healthcare NHS Foundation Trust (community physical and

Background Care home residents with advanced frailty often experience repeated acute transfers near the limits of clinical benefit, yet anticipatory planning may be absent until crisis admission. This audit assessed availability of comprehensive Advance Care Plans (ACPs) before transfer and whether acute admission was associated with reactive resuscitation-focused documentation. Methods A retrospective review was undertaken of 146 acute medical admissions from care homes to Prince Philip Hospital between 1 September 2024 and 30 April 2025. Electronic records were analysed for Clinical Frailty

Background The project was started as board round discussions were regularly taking over one hour, reducing the time available for ward work and causing team dissatisfaction. The team involved included the doctors on the ward, the senior nursing staff and members of the therapy teams. Methods In October 2025, a questionnaire was completed by team members asking how they felt board round could be improved. Improvements were then gradually implemented with verbal feedback throughout. Formal feedback was requested in January 2026, with a further round of interventions and feedback collected again

Introduction: People living with Parkinson's disease are frequently admitted to hospital, with many receiving care on frailty units. Timely medication administration for these patients is essential to reduce morbidity, mortality and length of stay. Current national evidence suggests that this is often not achieved. We therefore sought views from frailty unit staff to understand local barriers and develop a solution. A frequent theme was limited understanding of Parkinson's disease medications and the importance of timely administration. Based on these findings, we developed a 15-minute

Introduction:  Advance care plans (ACPs) powerful tools that outline an individual’s health preferences to aid healthcare professionals when considering treatment options for individuals who are at risk of losing capacity to make decisions. This quality improvement project was conducted to analyse the documentation of frailty, and advance care planning among patients discharged to a care facility from a geriatric ward; with one year follow up on patient outcomes. Method:  We conducted a retrospective study using discharge summaries, for patients discharged to a care facility from a geriatric

Introduction:  Advance Care planning and discussions around resuscitation are important, especially when resuscitation is deemed inappropriate. Dialysis patients have a higher number of co-morbidities and poorer physiological reserve than an average  patient. Therefore, it is important that advance care planning  and  resuscitation  status  is considered and documented appropriately  in these patients. Methods: Haemodialysis patients aged >65 years who regularly attend a dialysis unit in Morriston Hospital were included. Using Vital Data, Medical notes and Welsh Clinical Portal, their Charlson

Introduction Frailty is increasingly prevalent in ageing populations and contributes to rising age‑related conditions such as sarcopenia, which is linked to falls, functional decline and greater healthcare use. Early identification is recommended in EWGSOP2 (2019); SARC‑F offers simple screening, while handgrip strength (HGS) provides objective assessment but is harder to implement routinely. This observational study examined the feasibility of embedding Guideline‑aligned frailty and sarcopenia assessment across inpatient and outpatient services. Methods In March 2022, 70 older inpatients were

Background: Neck of Femur fractures (NoFs) are associated with significant morbidity, mortality and prolonged hospital admission. These make up a significant portion of the Trauma and Orthopaedic admissions at Weston General Hospital. Optimal management requires multidisciplinary assessment and timely optimisation to meet the national targets for management of fractures. A review of the clerking proforma prior to this audit found variability in the documentation quality and completeness. Aim: To assess baseline documentation quality in NoF admissions and evaluate the impact of a redesigned

Introduction In 2024 we conducted a service evaluation of our new stroke AI in Wales, Brainomix. We reviewed its sensitivity and specificity at identifying large vessel occlusions (LVO’s) on CT Angiograms (CTA’s) for our stroke patients. The purpose of Brainomix being to assist in rapid detection of LVO’s and support decision making around proceeding to mechanical thrombectomy for appropriate individuals. Multiple studies in recent years have demonstrated improved functional outcomes for patients receiving mechanical thrombectomy. Brainomix was hoped to be pivotal in bringing these

Introduction. Opioids are commonly prescribed to older adults but are associated with important adverse effects, including constipation, delirium, sedation, falls, respiratory depression and toxicity, particularly in patients with renal impairment. This quality improvement project assessed the safety and appropriateness of opioid prescribing among older inpatients. Methods. A prospective review was undertaken over four weeks across Newington and McDonald wards at Conquest Hospital, East Sussex Healthcare NHS Trust. Thirty inpatients aged ≥65 years who were prescribed an opioid were included

Introduction: Several studies explored the role of frailty in predicting outcomes in critically ill patients. Frailty has been identified as an independent risk factor for all cause morbidity poor outcomes, including mortality, longer hospital stays and complications Rockwood et al. (2005). Muscedere et al. (2017) found that frailty is associated with worse outcomes in patients receiving mechanical ventilation, however there is limited focus on NIV. While NIV is widely used for managing acute respiratory failure, its effectiveness across varying levels of frailty and comorbidity remains

Title: Optimising Guideline-Based Laxative Prescribing in Older Adult Inpatients: A Quality Improvement Project Introduction: Constipation is common in older adult inpatients and is associated with delirium, urinary retention, abdominal discomfort, prolonged hospital stay and increased polypharmacy. Despite national guidance, laxatives are frequently prescribed without adequate assessment of reversible causes or documentation of the indication. We aimed to improve guideline-based, individualised laxative prescribing on two geriatric wards, targeting 85% appropriate management within 8–12 weeks