Age and ageing最新文献

{"title":"Revision Joint Surgery in Orthopaedic Trauma Theatres: An Increasingly Complex Problem?","authors":"MJ Jaarsveld, Murray Connolly, Ryan Barter","doi":"10.1093/ageing/afag197.020","DOIUrl":"https://doi.org/10.1093/ageing/afag197.020","url":null,"abstract":"Introduction As rates of primary hip and knee arthroplasty rise alongside an aging population, a corresponding increase in revision joint surgery is inevitable. Indications include prosthetic joint infection, periprosthetic fracture/dislocation and mechanical failure of implant components. These procedures are technically complex with a risk of perioperative complications such as major blood loss. This study aimed to evaluate annual theatre resource utilisation for revision surgery at a major trauma centre and its evolution over time, and to characterise the complexity of this patient population. Methods A retrospective service evaluation was conducted of revision arthroplasty and periprosthetic fracture procedures performed in two orthopaedic trauma theatres 2019-2025. Data were extracted from electronic patient records and theatre management system. Results A total of 584 procedures were included. The annual number increased 227% from 52 in 2019 to 127 in 2025. Median anaesthetic time was 90 minutes (IQR 55-210) and surgical time 125 minutes (IQR 90-165). Patients had a median age of 75 (IQR 67-83) with 52% male. Median length of stay was 17 days (IQR 10-39). In-hospital mortality was 3.2% and 45% were discharged to a nursing home or other hospital. Discharge documentation was incomplete in 114 cases; of the remaining 470 patients, 87% had at least one documented co-morbidity, including cardiac (22.7%), respiratory (10.2%), renal disease (3%), and dementia/stroke (6.6%). Conclusions Revision joint surgery and associated perioperative care represents an increasing and resource-intensive proportion of the emergency orthopaedic workload. Patients are older, increasingly frail and with significant co-morbidities. The associated perioperative morbidity is reflected by prolonged hospital stay, discharge to nursing home and other care facilities and in-hospital mortality.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"33 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty Predicts Adverse Outcomes after Emergency General Surgery in Older Adults – A Multicentre Snapshot Audit on Frailty Prevalence in Irish Hospitals","authors":"Megan Power Foley, Mohammed Alazzawi, Carolyn Cullinane, Michael Devine, Mohamed Ismaiel, Czara Kennedy, Áine O’Neill, Nicola Raftery, Éanna Ryan, Conor Toale","doi":"10.1093/ageing/afag197.050","DOIUrl":"https://doi.org/10.1093/ageing/afag197.050","url":null,"abstract":"Introduction As the population ages, older patients with complex comorbidities are increasingly being admitted to hospitals with acute surgical pathology. Understanding the impact of frailty on unscheduled surgical care is needed to guide future service provision. This prospective collaborative study assessed the impact of frailty on outcomes after emergency general surgery. Methods Audit approval was granted for prospective snapshot study across eight hospitals. For fourteen consecutive days, all emergency general surgery admissions >60 years was screened for frailty using the Clinical Frailty Score. Electronic records were reviewed for demographics, comorbidities and inpatient course at 30 days, and the national death registry for twelve-month mortality. Outcomes between frail and non-frail patients were compared using SPSS. Results Across 112 call sessions, 277 patients >60 years were admitted. Mean age was 76.0 years (+/- 8.76) and 52% were frail (n=135/269). Across all admissions, 104 (41.6%) patients required a procedure and 46 (16.7%) required surgery. Similar numbers of frail and non-frail patients underwent surgery under general anaesthesia (14% vs 19.5%, p=0.264), though proportionally more frail patients required ICU care post-op (42% vs 22%). Out of 21 laparotomies, one patient was seen by a geriatrician. Frailty was associated with higher rates of any complication (p<0.001), nosocomial infection (p=0.013), cardiac morbidity (p=0.015) and delirium (p=0.023). Frail patients required significantly more medical consults (p=0.021) and MDT input (p<0.001), however only 16% were seen by a geriatrician (n=20/122). Frail patients had longer hospital stays (p=0.002), fewer discharges to home (p=0.004) and more 30-day readmissions (p=0.010). Significantly more frail patients were dead at one year (20% vs 8%, p=0.006). Conclusions High levels of frailty and frailty-associated morbidity were noted amongst emergency surgical admissions. Significant investment in collaborative pathways between surgeons and geriatricians is required to optimally manage this high-risk cohort.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"37 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared Decision-Making Documentation in Patients Considering Radical Cystectomy for Bladder Cancer","authors":"L Harrington, B Strasser, R Anders, C Hendry, J Dhesi, J Partridge","doi":"10.1093/ageing/afag197.014","DOIUrl":"https://doi.org/10.1093/ageing/afag197.014","url":null,"abstract":"Introduction Shared decision making (SDM) is a collaborative process in which clinicians and patients work together to make healthcare decisions, integrating clinical evidence with patient values and preferences. Radical cystectomy carries significant perioperative risks, necessitating high-quality SDM. This single centre quality-improvement project aims to evaluate and standardise SDM documentation for patients considering radical cystectomy. Methods Electronic records of all patients considered for radical cystectomy for bladder cancer over a one-year period were reviewed retrospectively. Data were collected from urology clinic letters evaluating SDM documentation; capacity to consent; content (surgical, medical and functional risks, alternative management, natural history without surgery, and use of numerical risk estimates); format (free-text prose or SDM tool). Results Eighty-seven patient records were reviewed, of which 83 were eligible for analysis. The median age was 73-years. SDM discussion was documented in 90.4% (n=75). Assessment of capacity to consent was not recorded in any case. Surgical risks were documented in 71.1% (n=58), with numerical risk estimates in 61.4% (n=51); medical risks were documented in 69.9% (n=58); risk of functional decline was documented in 1.2% (n=1). Alternatives to surgery were documented in 50.6% (n=42), and the natural history of disease in 15.7% (n=13). There was no documentation noting use of a SDM tool. Conclusions While SDM discussions are commonly undertaken in this patient cohort, documentation is variable, with key risks and the option of non-operative management frequently under-documented. Using a structured SDM tool, such as BRAN (Benefits, Risks, Alternatives and Do Nothing), would standardise documentation and may improve the quality, transparency and consistency of SDM.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"296 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Geriatric Assessment (CGA) in the Emergency Department (ED) Enables Detection of Cognitively Vulnerable Older Adults","authors":"Fiona Condon, Sarah Allen, Ellen Coakley, Marian Lyons, Aine O’Sullivan, Maeve Scannell, Therese Corry, Niamh O’Driscoll, Niamh Spillane, Denis Curtin","doi":"10.1093/ageing/afag197.046","DOIUrl":"https://doi.org/10.1093/ageing/afag197.046","url":null,"abstract":"Introduction Assessment of frailty syndromes allows identification and modification of significant risk factors for ED presentations. Research identifies cognitive impairment as an independent risk factor for injurious or multiple falls in older adults. Scores of 1, 2 or 3 in the 4AT assessment are suggestive of a cognitive vulnerability such as MCI. Studies demonstrate that without further assessment and tailored multi-disciplinary intervention, cognitively vulnerable older patients presenting to ED are up to 50% more likely to re-present for further care with the same acute need. The aim of this research was to identify the prevalence of cognitively vulnerable older adults presenting to ED with falls. Method Over a one-month period, consecutive patients presenting with a fall were assessed by the Frailty Interdisciplinary Team (FIT) using a standardised assessment. Data collected, as part of routine care, was prospectively entered onto Excel by a trained administrator. Age, gender, Clinical Frailty Score (CFS), 4AT score and presence or absence of prior dementia were recorded. Data were analysed using descriptive statistics. Results 128 patients were assessed during the study period. 7.8% (n=10) of patients ≥75 years, presenting to ED with a fall had a 4AT score of 1 to 3, with no previous dementia diagnosis. Mean age was 84.7 years (4 males, 6 females) and mean 4AT was 1.8. Conclusion FIT assessment effectively identified a cognitive vulnerability in a significant number of older adults presenting to ED with a fall. Detection of cognitive vulnerability will prompt a more detailed formal assessment of cognition and individualised interventions to support patients and/or carers, potentially reducing re-presentation to ED.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"9 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pubic Rami Fractures in the Frail Older Adult: A Neglected Injury","authors":"Sarah Allen, Aine O’Sullivan, Ellen Coakley, Fiona Condon, Maeve Scannell, Marian Lyons, Niamh O’Driscoll, Niamh Spillane, Therese Corry, Denis Curtin","doi":"10.1093/ageing/afag197.043","DOIUrl":"https://doi.org/10.1093/ageing/afag197.043","url":null,"abstract":"Introduction Pubic rami fractures, although commonly described as simple and stable fractures, are associated with significant morbidity in frail older patients. Similar mortality rates are reported compared to neck of femur fractures in patients aged ≥ 70 years. Patients with pubic rami fractures account for almost a fifth of all patients with fractures reviewed by The Frailty Intervention Team (FIT) (40). Method All patients assessed by FIT have standardized assessment completed. These data points are entered by a trained administrator onto an excel sheet. Over a three-month period, sixteen patients sustained a pubic rami fracture. 4AT, geriatric medicine review, bone health and discharge destination were all recorded as they are data points audited by the Irish Hip Fracture Database. Results Overall, 14 patients (88%) had a delirium assessment (4-AT) in the Emergency Department. Four patients had a 4AT of 4 or more and one had a score of 1. Fifty percent (n=8) of patients were reviewed by geriatric medicine with seven directly admitted under the service. All patients were mobilised on the same day of FIT review. 15 (94%) patients had a bone health review or plan documented. Seven patients were discharged home, five were transferred to a specific geriatric rehabilitation hospital to achieve the goal of returning home, two transferred to a local hospital for rehabilitation, one to long term care and one to hospice for end-of-life care. Conclusion FIT review improved detection of delirium, allowed for early mobilisation and bone health screening of this patient group. Although only half the patients had a direct geriatric review FIT multidisciplinary team was able to prompt delirium screening, falls assessment and bone health review.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"455 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NOFs Lead to Coughs: A Proactive Post-Operative Dysphagia Management Pathway for Hip Fracture Patients","authors":"Sinead Brosnan, Emma O’ Driscoll","doi":"10.1093/ageing/afag197.049","DOIUrl":"https://doi.org/10.1093/ageing/afag197.049","url":null,"abstract":"Introduction Neck of femur (NOF) fractures are high-risk injuries in older adults, frequently complicated by frailty and post-operative delirium. Evidence suggests 34% of NOF patients are dysphagic within 72 hours of admission (Smithard 2007). Aspiration pneumonia occurs in up to 15% of cases and triples 30-day mortality (Neuman 2014). Current referral models are often reactive; this project developed a dedicated \"NOFs Lead to Coughs\" clinical are pathway, specifically targeting the post-operative phase. Methods The pathway was designed using a \"Referral-Assessment-Management\" framework. Inclusion criteria were defined as patient’s ≥65 following surgical repair of a fragility hip fracture. The referral trigger was shifted from symptomatic coughing to a proactive mechanism based on post-operative cognitive status. Patients with a post-operative 4AT score ≥4, indicating likely delirium and associated swallowing vulnerability, are referred to Speech and Language Therapy (SLT) for screening. Results The resulting pathway prioritises three pillars: Referral: Automatic SLT screening triggered by pre or post-operative delirium (4AT ≥4) or persistent sedation following anaesthesia. Assessment: Clinical evaluation of alertness, postural stability, and airway protection, specifically addressing the fluctuating swallow safety seen during the post-operative window. Management: Implementation of evidence-based dysphagia management, which may include texture modifications and compensatory swallowing strategies. The pathway emphasises MDT coordination to ensure safe hydration and nutrition are maintained throughout the post-operative recovery. Conclusions Implementing a structured post-operative SLT pathway addresses a critical gap in delivery of comprehensive care for this patient cohort. By standardising screening based on post-operative delirium status (4AT), we can proactively mitigate aspiration pneumonia risk and improve clinical outcomes for this frail surgical population.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"16 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Falling into ICU: Outcomes and Resource Utilisation of Patients Admitted to ICU Following Neck of Femur Fracture Surgery","authors":"Caolan Concannon, Roisin Ni Dhomhnail, Niamh Geraghty, Tom Gordon","doi":"10.1093/ageing/afag197.026","DOIUrl":"https://doi.org/10.1093/ageing/afag197.026","url":null,"abstract":"Introduction Neck of femur (NOF) fractures confer a high mortality risk for older patients with an incidence of over 4000 people per year in Ireland. The high comorbidity burden in patients with NOF requires combined perioperative management involving orthopaedics and geriatric medicine. Postoperative management pathways vary between institutions and in hospitals without dedicated high-dependency postoperative care beds, intensive care unit (ICU) admission may be used to facilitate enhanced monitoring for high-risk patients. Understanding the organ support requirements of NOF patients admitted to ICU may help inform postoperative pathways and resource utilisation.​ Methods A retrospective chart review, not requiring institutional ethical approval of all NOF admissions to ICU between November 2024 and December 2025 with outcomes assessed at 3 months and 6 months post admission (N=31). Results Over half patients required no organ support. Three patients needed ventilatory and vasopressor support, and two required ventilatory support alone. Patients who required no critical care supports had a median ICU length of stay of 4.95 days (IQR 3.4-6.3 days). Patients who required organ support had a median ICU length of stay of 8.6 days (IQR 4.1-10.5 days). Conclusion Over half of the patients admitted to ICU required no organ support during their ICU stay. HDU level care or earlier step-down from ICU may be appropriate where available, reducing pressure on higher level critical care resources. This audit was not designed to capture admission indication which limits interpretation regarding the appropriateness of ICU admission, however it could inform policies regarding ICU utilisation and inform postoperative pathways following NOF fixation surgery.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"261 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Geriatric Medicine Input for Surgical Inpatients Using a Surgical Ward Board-Round Intervention","authors":"Kate McCarthy, Eoin Donnellan, Jerry Foley, Rebecca O’Sullivan, Mary Murphy, Kieran O’Connor","doi":"10.1093/ageing/afag197.024","DOIUrl":"https://doi.org/10.1093/ageing/afag197.024","url":null,"abstract":"Introduction Older surgical inpatients experience high rates of frailty, multimorbidity, and adverse outcomes. Evidence from the National Emergency Laparotomy Audit (NELA) and international audits supports the development of proactive perioperative geriatric services integrated with surgical care. This project reviews an existing geriatric medicine consult service to identify opportunities for service improvement. Methods A quality improvement approach was employed. A process map of the existing geriatric consult pathway was developed to understand referral flow and access points. Over a one-month baseline period, data were collected on the source and volume of consult requests. Analysis of these data informed the development of a problem statement, leading to the implementation of a single change intervention. As part of a Plan–Do–Study–Act (PDSA) cycle, a registrar in geriatric medicine attended twice-weekly board rounds on one selected surgical ward to facilitate proactive case identification. Following implementation, consult activity was re-analysed over a subsequent one-month period. Results Baseline data identified 11 geriatric medicine consult requests over one month, of which 4 (36.3%) originated from surgical teams. In the post-intervention period, 15 traditional consult requests were received, with 3 (20%) from surgical teams. However, an additional 7 surgical patients were identified through board-round discussions. This amounts to 10 surgical patient consults out of 22 overall consults (45%) identified in the post-intervention period. Conclusions Introduction of a single, low-resource intervention—geriatric medicine attendance at surgical ward board rounds—increasedthe identification and assessment of surgical inpatients requiring specialist geriatric medicine input. Sustaining this change will require continued stakeholder engagement and integration into routine surgical workflows. Ongoing data collection is evaluating the impact of this model on key outcomes, including time to theatre, length of stay, and discharge destination.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"17 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Phased Quality Improvement Approach to Reducing Routine Preoperative ECGs in Low-Risk Ophthalmic Surgery","authors":"Dorothy Lim, Monica Tan","doi":"10.1093/ageing/afag197.001","DOIUrl":"https://doi.org/10.1093/ageing/afag197.001","url":null,"abstract":"Introduction Despite a mature healthcare system grounded in evidence-based medicine, routine preoperative electrocardiograms (ECG) remain commonly performed in patients undergoing low-risk ophthalmic surgery, contrary to international guidelines. Our institution performs approximately 20,000 cataract surgeries annually. Efforts to remove routine ECG testing encountered significant resistance. Unnecessary ECGs and downstream referrals strain healthcare resources, impair patient experience, and delay sight-restoring surgery, particularly for elderly patients. This quality improvement project reduced routine preoperative ECG use in low-risk ophthalmic surgery, aligning institutional practice with international recommendations. Methods A three-phase quality improvement project was conducted. In phase one, 1,000 patients scheduled for cataract surgery under local anaesthesia with sedation were randomized to either routine preoperative ECG or ECG only if clinically indicated. Primary outcomes were adverse medical events and surgery postponement. Phase two expanded removal of routine ECGs to all cataract surgeries under sedation over six months (10,291 cases), assessing cancellations and adverse events. Phase three involved all low-risk ophthalmic surgeries under sedation, with a six-month audit of 9,955 cases to monitor significant perioperative events. Results Phase one showed no significant difference in cancellation rates, intraoperative events, or unplanned admissions between routine and non-routine ECG groups (4.0% vs 3.2%, p=0.79). In phase two, 10,291 cataract cases had 67 cancellations (0.65%), compared with 3% cancellations during a prior period. Cardiology referrals decreased by 57% (275 to 116, p<0.0001), with estimated cost savings of SGD 733,738. Phase three achieved an 83% reduction in ECG use, with no preventable perioperative events. Conclusion Routine preoperative ECGs offer no clinical benefit in low-risk ophthalmic surgery, and their removal optimises patient care and healthcare resource utilisation.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"111 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Analgesia- a Geriatric Emergency Medicine Audit in Patients Presenting with Head Injuries","authors":"Owen Gallagher, Anna O’Leary","doi":"10.1093/ageing/afag197.034","DOIUrl":"https://doi.org/10.1093/ageing/afag197.034","url":null,"abstract":"Introduction Older adults are less likely to receive analgesia in the emergency department. Untreated pain is associated with longer stays and increased complications. The Royal College of Emergency Medicine (RCEM) guidelines recommend adequate analgesia administration within 15 minutes of presentation. We performed an audit to assess time to analgesia, implemented recommendations and reaudited noting improvement in administration times. A significant proportion do not receive analgesia begging the question are we adequately assessing and treating pain in this cohort? Methodology: We audited patients ≥75 years presenting to the Emergency Department. Our inclusion criteria was: ‘Head Injury’ documented at triage. This population sample was reviewed on the Emergency Department MAXIMssystems by selecting patients who met both criteria. Each patient’s Emergency Department drug kardex was reviewed. It was noted whether the patient had received analgesia and the time it was administered. This was compared to the registration time for each patient and the difference between the two calculated. We noted that this was significantly longer than the recommended 15 minutes and enacted an education programme for staff to endeavour to improve time to analgesia. Results The initial results showed that the average time from registration to analgesia was just under 3 hours, repeated interventions throughout February 2026 show significant improvement in time to analgesia and final results are expected within the next 14 days. Conclusion A significant proportion of older patients presenting to the Emergency Department with Head Injury will receive analgesia with an average wait time of 3 hours, our intervention shows encouraging improvement in these times.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"37 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}