Posters

Introduction Venous thromboembolism (VTE) risk following acute stroke is high. Current guidelines recommended intermittent pneumatic compression (IPC) stockings for up to 30 days in those who are immobile following acute stroke. The concern post-stroke is haemorrhagic complications when using low molecular weight heparin (LMWH). The CLOTS3 trial favoured IPC for safety in the first 30 days. However, in many cases, doses suitable for VTE prophylaxis can be used but with caution if IPC cannot be used. Method A spot audit of patients current VTE prophylaxis was undertaken in a stroke

Introduction In today's healthcare practice, many patients live longer with multiple health issues, often in a frail or terminally ill state. Their quality of life doesn't necessarily improve. These patients require optimal supportive care that respects their dignity. Advanced Care Plans (ACPs) are crucial here, facilitating person-centered discussions about future care preferences while the patients have the mental capacity for meaningful participation. We aim in this study to assess how many patients in General Internal Medicine department would benefit from ACP and compare that to our

An 80 year old man living independently with his wife presented with progressive unsteadiness, generalised weakness and muscle aches over 2 months, following a short episode of flu-like symptoms. Systems review revealed shortness of breath, a hoarse voice, 2kg weight loss and occasional non-drenching night sweats. Bloods showed elevated WCC, CRP and ESR. He was started on 20mg of prednisolone for a working diagnosis of polymyalgia rheumatica. These symptoms did not improve, even after this increased to 30mg. He was admitted to hospital after he developed left leg weakness evolving over the

There is unequivocal evidence to support Perioperative care for the Older Person Undergoing Surgery (POPS) services. However, POPS services are not available in all Trusts offering surgery, including Royal Surrey Foundation Trust (RSFT). The necessity for POPS services will continue to grow with increasing numbers of older people undergoing elective and emergency surgery due to: changing demographics, surgical and anaesthetic advancements, shifts in culture and patients’ expectation of healthcare (1). A RSFT POPS steering group was convened to explore the current orthopaedic elective pathway

Introduction There is a high prevalence of diabetes in patient populations undergoing Vascular Surgery. Appropriate and responsive management of diabetes in the perioperative setting is critical for reducing morbidity and perioperative complications e.g. diabetic emergencies, poor wound healing, delirium. The aim of this project was to review current practice for perioperative management of older people with diabetes against guidance outlined by the Centre for Perioperative Care (CPOC) on a regional vascular surgery ward. Methods A retrospective observational evaluation design was conducted

Introduction: Incident frailty is common among older adults with diabetes mellitus. We have previously demonstrated that elevated serum levels of the soluble receptor for advanced glycation-end products (sRAGE) predict mortality in frail older adults. However, the evidence that sRAGE is associated with higher mortality in older adults with diabetes mellitus is rather inconsistent. Therefore, the aim of this study was to investigate whether frailty status influences the relationship between sRAGE and mortality in older adults with this diabetes mellitus. Methods: Three hundred and ninety-one

Introduction Shared decision making (SDM) is a vital element in ensuring a more personalised approach to care. The Peri-operative Care of Older People in Surgery (POPS) Team adopts enhanced SDM in frail patients referred for elective urological or colorectal surgery using the BRAN (benefits, risks, alternatives, nothing) approach. In frail populations, there is a complex balance between providing appropriate access to surgery and minimising exposure to potentially harmful procedures. SDM can help to negotiate this balance. This study aimed to evaluate the patient perception of the SDM process

Introduction NELA (National Emergency Laparotomy Audit) and British Geriatric Society guidance states patients aged ≥ 80 years, or ≥ 65 years and frail, should have a comprehensive geriatric assessment (CGA) from a perioperative frailty team within 72 hours of admission or critical care step-down. Patients aged ≥ 65 years represented 55.3% of those undergoing emergency laparotomy; and frailty doubled the mortality rate in this group, but post-operative geriatrician review was associated with reduced mortality (NELA project team, RCoA, 2023). Method The Perioperative Care of Older People

Introduction Authoritative medical organisations including the Resuscitation Council UK, NHS and BMA all state that Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions should only be relevant to CPR and should not impact other decisions about care and treatment. We set out to examine the reality of decision making in clinical practice. Methods We circulated a clinical scenario of a patient deteriorating with COVID-19 after hip fracture to 128 members of the consultant and trainee geriatrician WhatsApp groups in Wales. Recipients were blindly randomised to one of two versions

Abstract Content - Introduction: Delirium, characterized by disturbances in attention and consciousness, is common in individuals with pre-existing medical conditions, particularly the elderly, but can affect people of any age. It can lead to significant morbidity, mortality, prolonged hospital stays, increased healthcare costs, and long-term cognitive decline. Despite its impact, delirium is often underdiagnosed and undertreated, underscoring the need for better diagnostic strategies. The 4AT tool, recognized by NICE, is valued for its rapid delirium assessment, unlike the AMT-10, which is

Introduction Frailty is a clinical state that predisposes to patients to clinical deterioration in response to minor stressor events. Frailty tends to be more prevalent in patients with chronic conditions such as Chronic Obstructive Pulmonary Disease (COPD). Therefore, we aim to investigate the influence of clinical frailty on mortality in COPD patients. Methods Data collection from electronic records for patients seen in Ysbyty Ystrad Fawr, Neville Hall Hospital, Grange University Hospital or Royal Gwent Hospital between 5-17th June 2024 was completed as part of patient input to the National

Background A mechanism for improving inpatient communication with patients and their families by the multidisciplinary team was desired. Introduction Patients and their families were invited to a 'What Matters to Me' meeting within a few weeks of transfer to a 43 bed community rehabilitation hospital. The 'What Matters to Me' meetings were booked by nurses with families via an invitation letter given during visiting. The letter outlined the purpose and format of the meeting. The patient, family, nurse, therapist, physician associate or junior doctor and consultant participated. A small number

The aging population is often burdened with multiple comorbidities, leading to polypharmacy, which increases risk of adverse drug reactions . Anticholinergic medications are commonly prescribed to elderly patients for various conditions, yet they are associated with a range of adverse effects, including cognitive impairment, falls, and even increased mortality. The Anticholinergic Burden (ACB) score is a validated tool used to assess the cumulative burden of anticholinergic medications in patients. This clinical audit is aimed to evaluate the use of the Anticholinergic Burden (ACB) score as a

Aims Understanding patients’ wishes regarding CPR before surgery is crucial. This study aims to assess the impact of a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision on anaesthetists' actions during theatre. Methods We used WhatsApp, to present a scenario of an 83-year-old with ischemic heart disease, cognitive impairment, and an acute hip fracture. Anaesthetists were asked how they would handle various intraoperative events and whether a prior DNACPR decision would influence their actions. Results A total of 74 UK anaesthetists, all but one of them consultants, completed the

Vitamin D deficiency has become commonplace, especially in older people. Given the role it plays in bone health and falls prevention, as well as the growing evidence of its extra-skeletal actions, it is important to treat vitamin D deficiency adequately. Our practice has been 2 to 3 weeks of daily treatment with 50,000IU ergocalciferol as a loading dose. However, recent guidelines recommend half this total cumulative dose given over a period of 6 to 8 weeks. Rather than promptly following the guidelines and changing our practice, we opted to conduct a quality improvement project (QIP) looking

Introduction Surgical interventions for older adults are increasing as the population ages. This demographic has a higher perioperative risk. Perioperative care through virtual wards (VWs) is a new service, allowing patients to remain at home. We compared operational and clinical metrics between two age groups (65+ and <65 years) receiving surgical inpatient care through a VW service to evaluate safety and efficacy. Methods The VW service at Wrightington Wigan and Leigh (WWL) NHS Foundation Trust cared for patients at home using the Current Health (CH) platform for medical and surgical

Introduction: As awareness of hospital-associated deconditioning increases, services to prevent hospital admissions and provide discharge support for older adults are expanding, aiming to reduce admissions and the risks associated with prolonged hospital stays. A Welsh Government IQS titled “Older People and People Living with Frailty” published in January 2024 identifies a need to shift our health and social care system from prioritising reactive crisis management to a ‘place-based’, community-focused approach that emphasises proactive identification and management of frailty. The CTMUHB

Introduction It is predicted that over 4,000,000 patients will be on an elective waiting list in England by 2030 (1) with increased demand, age and frailty following COVID (2). The importance of early assessment of frailty and geriatrician input to allow optimisation and shared decision making is key. A Geriatrician led perioperative clinic was established in Swansea Bay for patients on elective general surgical waiting lists in September 2023. Method Using an electronic Power Business Intelligence frailty flag, we highlighted patients and screened either electronically or via telephone using

BACKGROUND: At Sheffield Teaching Hospitals, an Older Surgical Patients Pathway (OSPP) began in 2014, introducing a Consultant Geriatrician working in a liaison role within General Surgery. BGS reports in its 'Case for more Geriatricians' that the number of people aged over 85 is set to double by 2045. An increase in patient age and complexity is already being seen across a range of services including admissions to general surgery. We look to characterise this increase to make the case for an expansion of the OSPP service. METHODS: We identified patients aged over 75 admitted under General

Introduction In 2021, the Welsh Government launched the “All Wales Dementia Care Pathway of Standards”, which the Cardiff and Vale University Health Board (CVUHB) Memory Assessment Service (MAS) works under (1. Welsh Government, 2021). This service evaluation aims to evaluate the CVUHB MAS diagnostic pathway against these standards. Method This retrospective review analysed 299 referrals to the CVUHB MAS from August 2020-2023. Data was collected via referral and clinic letters, focusing on demographics, referral sources, diagnostic timelines and clinical outcomes. Results Patients had a mean