Posters

Abstract Nicotine has been investigated in prior studies for its analgesic effects and its impact on postoperative nausea and vomiting (PONV), yet results have been inconsistent. Objectives This systematic review and narrative synthesis evaluates the effects of perioperative nicotine administration on postoperative pain control and PONV in patients undergoing general anesthesia. Methods A systematic literature review was conducted, and findings were summarized narratively. Comprehensive searches were performed in PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google

Introduction Influenza infection poses a significant risk to patients with chronic heart failure (HF), mediating myocardial inflammation, haemodynamic instability, and acute decompensation. NICE guideline NG106 recommends annual influenza vaccination for all adults with HF. Despite this, vaccination uptake in this population remains inconsistently monitored at the primary care network level. This audit assessed compliance with this recommendation across the Watling Street Primary Care Network (PCN) in 2024. Method A retrospective audit of all patients with a coded diagnosis of chronic HF

Introduction Upon conducting a baseline audit assessing Colchester Hospital’s Care of the Elderly (COTE) wards’ adherence to NICE Quality Standard 63 — which states adults must have their diagnosis of delirium communicated to their GPs on discharge — it was found that compliance with this standard was suboptimal. This adversely impacts continuity of care. Data was collected across four COTE wards (Tiptree, D’Arcy, Birch and Peldon) for December 2023. Out of 80 patients, only 34 had their diagnosis communicated to GPs, meaning only 42.5% adherence to NICE guidance. This highlighted a clear gap

Introduction Frailty is a key predictor of adverse outcomes in hospitalised older adults. Assessing change in Clinical Frailty Score (CFS) from admission to discharge may reflect inpatient functional decline and quality of care. Method A retrospective audit of 40 medical inpatients was conducted at a district general hospital. Frailty was assessed using the Rockwood Clinical Frailty Scale at admission and discharge, with input from the multidisciplinary team including occupational therapists and nursing staff. Admission source (e.g., home, care home) and discharge destination (e.g., home

Background Older adults with frailty presenting with trauma or requiring emergency surgery represent a high-risk population with complex medical, cognitive and functional needs. While specialist older persons surgical services are increasingly established in tertiary centres, many district general hospitals (DGHs) lack dedicated frailty provision for emergency surgical patients. This variation affects patient outcomes, adherence to national standards and workforce sustainability, highlighting the need for pragmatic, deliverable models within existing DGH resources. Our aim was to develop and

Intro The geriatrics surgical liaison MDT aims to identify surgical patients with frailty who would benefit from comprehensive geriatric assessment (CGA). This involves taking referrals from both the surgical team and AHPs. There are weekly MDT meetings to identify rehab goals and any other relevant aspects of CGA assessment. Aim To determine the outcomes of the geriatrics surgical liaison MDT. Methods All patients who were discussed at the MDT meeting in a 14-week period from March to June 2026 were identified. A review of case notes was carried out to determine outcomes e.g. number of times

1.Introduction The Emergency Laparotomy and Laparoscopy Scottish Audit (ELLSA) commenced in 2019. This partly considers whether a geriatrician has reviewed patients undergoing emergency laparotomy aged over 65 with frailty or over 80. The ELLSA 2024 report showed the national average geriatrician review was 32.3% (target 75%). Glasgow Royal Infirmary had no dedicated laparotomy in-reach geriatrician process; therefore, we started developing a service. 2. Method Commencing January 2026, a spreadsheet of all patients over 75 for geriatrician review was made. Referral was placed by a dedicated

Introduction: Accurate discharge summaries are essential for ensuring continuity of care, particularly for frail orthopaedic patients. High-quality discharge communication has been associated with reduced post-discharge adverse events, medication errors, and hospital readmissions, while improving patient understanding of management plans. Following feedback from general practitioners regarding incomplete discharge summaries, we undertook this quality improvement project to evaluate the quality of orthopaedic discharge summaries and identify areas requiring improvement to support safe

Background: Individuals aged 60 years and above are undergoing surgical procedures, including resections for solid organ tumours. Surgery poses a significant physiological stress that disrupts normal homeostasis by affecting both the neuroendocrine and immune systems. When coupled with frailty, tumour-related metabolic demand and multiple co-morbidities, surgical stress predisposes older adults to poorer surgical outcomes, lower quality of life and institutionalisation. Prehabilitation aims to improve postoperative outcomes and enhance tolerance to surgical stress by optimising patients’

Introduction: Hip fractures are associated with significant mortality, prolonged hospital admission and loss of independence in older adults. Several risk assessment scores, including the Clinical Frailty Scale (CFS), American Society of Anaesthesiologists (ASA) grade, Nottingham Hip Fracture Score (NHFS) and RHMP30 score, are used to estimate patient risk. This study compared the association between these scoring systems and clinically relevant outcomes following hip fracture surgery to explore whether any score demonstrated a more consistent relationship with patient outcomes. Methods: A

Introduction The NHS is under unprecedented financial pressure, and emerging perioperative services for older people undergoing surgery are often difficult to fund, even where economic modelling suggests potential savings. After securing Royal Surrey Charity funding to join Cohort 4 of the NHS Elect POPS Improvement Collaborative, it became clear that funding for a new proactive POPS service would not be available. The team therefore explored what could be achieved within existing funded services for patients living with frailty who were referred for hip or knee arthroplasty. Method Quality

Introduction: Sigmoid volvulus (SV) is a common cause of large bowel obstruction in older adults, carrying high morbidity, mortality, and recurrence. Following a previous audit, a local SV management pathway based on international guidelines (Tian et al., 2023) was introduced in 2024 to standardise care. This re-audit evaluated pathway compliance and its clinical impact. Methods: Data was extracted retrospectively from electronic inpatient records for all patients admitted with SV between October 2024 and May 2026. Patient status at time of audit was also noted. Measures included demographics

The Orthogeriatric pre-operative assessment clinic was established in 2021 at the Nuffield Orthopaedic Centre, Oxford, to support frail older adults being considered for elective orthopaedic procedures, including complex revision surgery. We evaluated outcomes for 50 consecutive patients assessed by the service. We interrogated the notes of 50 patients seen looking at demographics (including age and frailty), comorbidities, origin of referrals, wait times, issues identified in clinic, operation type, post-operative outcomes and mortality. The average wait time for a clinic review was 2.5 weeks

Orthostatic Hypotension (OH), defined as a systolic blood pressure (SBP) drop >=20mmHg or diastolic blood pressure (DBP) drop >=10mmHg within three minutes of standing, is associated with falls, cardiovascular risk and cognitive impairment. NICE recommend performing lying and standing blood pressure measurements during falls assessments NG249, 2025. Despite this, OH may being underdiagnosed, a primary care survey showed a symptom driven approach to OH diagnosis that may exclude those with advanced frailty and cognitive impairment McDonagh, 2025. Method Our cohort was 9,052,916 patients aged 60

Background: Heart failure is a predominant cause of hospital admissions, and this mainly affects adults over the age of 65. Extensive research has shown that four-pillar medical therapy increasingly improved clinical outcomes for this age group. Despite this, adherence is relatively poor, particularly in frail adults, to this guideline-directed medical therapy. Thus, it is vital to explore the reasons for non-adherence so that we can treat patients more holistically and continue to improve clinical outcomes in this population. Aim: to evaluate other imperative outcomes of quadruple therapy for

Introduction There has been a global increase in the number of older adults undergoing elective and emergency surgery in the last 50 years. Frailty, cognitive dysfunction and multi morbidity negatively impact peri-operative outcomes. Roughly 15% of patients over 65 having surgery at Kings College Hospital are frail but previously there was no pathway in place to perform timely CGA or optimise for surgery. Methods We have set up a Geriatrician led pre-operative clinic for older adults being considered for cancer surgery. We see patients who are over 65 with a CFS of 4 and above with either

Compliance with NELA and BGS-CPOC Standards in Older Patients Undergoing Emergency Laparotomy: A Single-Centre Audit Introduction Frailty is associated with increased postoperative complications, prolonged hospital stay and higher mortality following emergency laparotomy. The British Geriatrics Society–Centre for Perioperative Care (BGS–CPOC) and the National Emergency Laparotomy Audit (NELA) recommend: frailty assessment within four hours of admission in all patients aged ≥65 years; comprehensive geriatric assessment (CGA) for patients with frailty and all patients aged ≥80 years; and

Introduction: Clinical frailty affects over 1.5 million people in the UK in 2025. The Clinical Frailty Scale (CFS) is a validated tool recommended nationally for assessing frailty in all emergency hospital admissions over 65 years. Frailty assessment is important for surgical admissions as a CFS score ≥4 is independently associated with increased rate of complications and mortality. The aim of this project is to improve the assessment of frailty in emergency urology admissions at the Alexandra Hospital using the documentation of a CFS score as a primary outcome and social history documentation

Introduction Older people living with frailty admitted under General Surgery frequently have complex medical needs and experience poorer surgical outcomes. Comprehensive Geriatric Assessment (CGA)-based perioperative services are therefore recommended. ¹–⁴ Baseline evaluation at NHS Grampian demonstrated limited frailty recognition and no geriatrician-led reviews despite substantial unmet need and an established geriatrics liaison service. A medical student-led quality improvement project was undertaken during the wider development of a General Surgery Perioperative Medicine for Older People

Introduction With an ever-growing frail population, the workload on ortho-geriatric services continues to increase and strategies to prioritise these resources must be identified. Within Aberdeen Royal Infirmary (ARI), the service predominantly comprises a team of ANPs with liaison consultant cover. The department was recently selected for a trial of an increase to daily consultant cover, with Clinical Frailty Scores (CFS) utilised as the triage tool for highlighting those with the highest frailty for increased and early senior medical input. Method Data from a two-week period in December 2025