Posters

Background: Involvement of Geriatricians in peri-operative assessment acknowledges the altered physiology of frail patients and helps to evaluate realistic outcomes as part of patient-centred shared decision making. This is with the aim of addressing modifiable risk factors, preventing complications, preparing for a realistic recovery and ensuring that treatment options are aligned to what is important to the patient. There is data suggesting improved survival following geriatric peri-operative assessment but little analysis from the patient’s perspective; their thoughts about the shared

Introduction With a growing number of older adults undergoing cardiac surgery, there is increasing emphasis on recovery outcomes beyond morbidity and survival. Many patients prioritise cognition and independence, yet these domains are not routinely assessed. Frailty, multimorbidity and cognitive vulnerability are common in this population, increasing risk of poor longer-term outcomes. However, longitudinal evidence describing cognitive and functional trajectories after surgery remains limited. We characterised cognitive and functional trajectories of older cardiac surgical patients over 5

Abstract Background: The global population of people aged 65 years and over is expected to rise from 761 million in 2021 to 1.6 billion by 2050. Many of these older adults have multiple comorbidities and functional impairments that make them particularly vulnerable during acute hospitalisation. Engagement in meaningful activities can be vital to older people’s care, particularly in acute hospitals. Evidence suggests that such engagement can have a positive impact on the patients’ hospital journeys. To ensure individualised support, it is important to understand the purpose of meaningful

Introduction: Sarcopenia constitutes the progressive loss of muscle mass, strength and function, most commonly in adults ≥60 years old. Associated adverse outcomes include immobility, loss of independence, falls, fractures and increased mortality. Predisposing risk factors include aging, comorbid disease and malnutrition. Malnutrition is common amongst older adults and low protein intake is strongly associated with sarcopenia. Dietary protein intake as a risk factor for sarcopenia and subsequent fracture risk is poorly understood. This systematic review aimed to ascertain the relationship and

Introduction This quality improvement (QI) project aimed to enhance patient experience and safety by reducing fluid fasting times by embedding the recently introduced "Sip til Send" policy in our acute orthopaedic trauma unit. Our concern was that older patients with hip fractures, who are often living with frailty and at high risk of complications, were being kept Nil by Mouth (NBM) for extended periods before operative intervention The "Sip Til Send" policy supports eligible patients in consuming clear fluids (170 mL/hour) until transfer to theatre with a reduction in distress, thirst

Background For patients aged ≥65 awaiting elective hip or knee surgery to be appropriately referred to a Perioperative Care of the Older People Undergoing Surgery (POPS) clinic, an accurate Clinical Frailty Scale (CFS) score is essential. Following the launch of a trial POPS clinic at Royal Surrey Foundation Trust, we compared referral letter CFS scores with those assessed by frailty-trained professionals. 75% of referrals lacked a CFS score, 12.5% differed, and 12.5% matched. To improve scoring accuracy and support appropriate referrals, we developed a CFS Scoring Toolkit, including a patient

Background: TEP’s are a tool used in acute hospital admission to guide appropriate care in the event of deterioration. TEP’s, a gold standard in the SIGN 167 guideline, help ensure that care aligns with the patients’ and families’ wishes. Though all patients should ideally have one on admission, this can be challenging to achieve. Patients with CFS (Clinical Frailty Scale) >5, NEWS >5, DNACPR, or progressive conditions, however, are at higher risk of deterioration and ensuring a valid TEP is in place is vital. Aim: To increase the number of patients in the Orthopaedic ward with a valid TEP in

INTRODUCTION Calcium-sulphate beads (CSB) are bio-absorbable antibiotic carriers which are used to manage surgical site infections as well as fill dead space. Iatrogenic hypercalcaemia from using CSB is a rare but potentially serious adverse effect. METHOD In this case report, we describe a patient who developed symptomatic hypercalcaemia secondary to using CSB during a Girdlestone excision arthroplasty. RESULTS An 86-year-old woman with a recent hip hemiarthroplasty for hip fracture developed a deep wound infection. Despite debridement and washout and prolonged intravenous antibiotics, her

Introduction: The anticholinergic burden (ACB) has been increasingly recognized as a modifiable risk factor that can contribute to falls, cognitive impairment, and frailty in older adults. Reducing ACB through medication review can potentially lower fall risk and ease strain on healthcare systems. This study aims to identify common contributors to ACB in older adults admitted with falls and evaluate whether ACB assessment was documented at hospital admission. Methods: We conducted a retrospective audit of patients aged >75 years admitted with a coded diagnosis of falls to an elderly care unit

A Project on Inpatient Falls: Are We Adequately Addressing Bone Health? Introduction Inpatient falls in older adults frequently lead to fragility fractures, with femoral fractures occurring in up to 82% of cases (RCP, NAIF 2023). These injuries significantly impact long-term morbidity and cost the NHS an estimated £4.4 billion annually (ROS, 2022). Despite tools like FRAX and national guidance (NOGG, 2021; NICE, 2022), bone health assessments remain inconsistently performed in the inpatient setting after a fall. Objectives To evaluate whether inpatients who experienced falls received

Introduction: Frailty is common among older surgical patients and associated with poorer post-operative outcomes. Therefore, identifying at-risk patients for peri-operative optimisation is vital to improve surgical outcomes, yet national audits reveal it remains under-assessed (1). A review of a surgical ward showed that 0% of patients aged over 65 had a Rockwood Clinical Frailty Score (CFS) documented within 48 hours of admission. This QIP aimed to increase timely CFS documentation to 50% by January 2025 and 80% by June 2025 through structured interventions. Method: Following initial

Introduction The POPS (Perioperative medicine for Older People undergoing Surgery) service at Wye Valley NHS Trust has been established since August 2024. During this year, the service has been evolving, and we have been evaluating its impact. This has also involved working with NHS Elect through the POPS-SUp project. As well as the data we have gathered, during the past year there have been many learning points about starting a new service. Method Throughout this year we have used quality improvement methodology to help shape our projects, such as driver diagrams and statistical process

Introduction Medications with anticholinergic burden are associated with falls and cognitive decline in elderly. About 30% of people aged 65 years and over in the UK have a fall at least once each year, increasing to 50% at the age of 80 and over. Method The last 100 patients admitted to the Frailty unit with falls were identified and Anticholinergic Burden (ACB) scores calculated on admission and at discharge. Patients were defined as having a positive (ACB≥1) or negative (ACB=0) ACB score. Drugs responsible for ACB score were identified and medication changes assessed. Results 75 out of 100

Introduction: With an ageing population, identifying frailty aids reduction of adverse postoperative outcomes. Centre for Perioperative Care - British Geriatrics Society ‘Care for People Living with Frailty’ guidelines state all patients aged >65 should have a documented Clinical Frailty Scale (CFS) score at pre-operative assessment. If CFS≥5, cognitive assessment should be documented and Comprehensive Geriatric Assessment performed. This audit aimed to assess frailty documentation at pre-operative anaesthetic assessment to support introduction of a specialist perioperative frailty pathway

Introduction Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in older adults. More than 70% of adults develop CVD by 70 years of age, among whom more than two-thirds also develop non-CVD comorbidities. There have been recent advances in CVD management but how we apply these to deliver integrated care to the elderly population is key. Thus, there is a clear need for educational strategies that integrate geriatric principles into cardiovascular training. Objectives To design and pilot a structured six week teaching programme in geriatric cardiology addressing

Background: ​Frailty is a multidimensional syndrome characterised by diminished strength, physiological reserve and increased vulnerability. Psychiatric inpatients are a high‑risk, often overlooked population. They typically have reduced life expectancy and are frequently excluded from most research, which leaves their complex healthcare needs unmet. By identifying frailty in this cohort, clinicians can more accurately stratify risks and tailor interventions to each patient’s unique vulnerabilities, and ensure that frailty considerations inform best‑interest decisions. Closing this critical

Introduction: The head-up tilt test (HUTT) is a common diagnostic test in patients presenting with syncope. A fast Italian protocol for HUTT shortens the traditional protocol from 40 to 25 mins (5 min supine phase, 10 min passive phase, 10 min GTN phase). This has been demonstrated to be as sensitive and specific in identifying vasovagal syncope in young adults as the traditional protocol, but not in older adults. We aimed to determine in our practice what proportion of positive results identified using the traditional Italian protocol, could have been identified using the fast Italian

INTRODUCTION Postural hypotension is a significant modifiable risk factor for inpatient falls in older adults. National guidelines recommend lying and standing blood pressure (LSBP) measurement for patients at risk of falls. On our geriatric wards, which care for acute, long-stay and orthogeriatric patients, we observed inconsistent LSBP documentation and delays in identifying postural hypotension. Staff reported difficulty locating LSBP records and a perception that fall prevention was being deprioritised in comparison to post-fall care. This project aimed to assess current practice and

Introduction: One-third of people aged ≥65 years fall at least once a year. Exercise on land reduces falls by up to 34% and fallers by >15%. Exercise on land may sometimes be challenging, e.g., for very frail people with high risk or fear of falling, people with painful joints, obesity and other comorbidities. Aquatic exercise may have positive effects on falls reduction, but research on it is sparce. The aim of this study was to design and deliver an aquatic exercise therapy intervention for falls prevention, and investigate its feasibility and acceptability for older adults with high fall

Introduction Delirium is a recognised complication of emergency surgery and is associated with unfavourable clinical outcomes. Previous work has suggested that delirium is under-diagnosed. Here we describe risk factors for, and the clinical impact of delirium in an older-adult emergency laparotomy cohort. Methods Routinely collected data on emergency laparotomy patients ≥ 65 years admitted to The Grange University Hospital from November 2021 to April 2025 were included. Delirium was scored prospectively using the 4-AT score. Frailty was defined as Clinical Frailty Score (CFS) ≥ 5. Analysis was