A Pilot Older Persons Trauma Service at a University Teaching Hospital and Designated Trauma Unit

Abstract Background Early Comprehensive Geriatric Assessment (CGA) and Multidisciplinary Team (MDT) intervention is one of 12 core principles of the Management of Major Trauma in Older Adults. At our Model 4 University Teaching Hospital, a designated Trauma Unit, all low-impact hip fracture patients aged 60 and above are seen by the Orthogeriatric Service, however due to staffing constraints, other older orthopaedic trauma patients are not routinely seen. In early 2025 we piloted an Older Persons Trauma Service, as part of an Aspire Fellowship programme, to provide Orthogeriatric care to older adults who had sustained a fracture, other than hip fracture, due to trauma. We emulated the care provided to hip fracture patients, i.e. CGA focusing on preventing future falls and fractures. Here we present some patient demographics of the pilot service. Methods Included patients were aged 75 and above, admitted under Orthopaedics on an Orthopaedic ward, with a fracture(s) (other than hip fracture) due to trauma. Patients were seen and followed by a Clinical Fellow and discussed at weekly MDT. CGA was conducted for all patients. Results Forty-one patients were reviewed during the c. 14-week pilot service. Average age was 82, Clinical Frailty Scale ranged from 1 to 7. Two thirds were female (n = 27) and 68% were from out of county (n= 28). The most common fractures were C-Spine fractures (24%), followed by ankle fractures (20%). Most injuries were from low falls. Feedback to date has been positive from patients, carers, and the MDT, and service evaluation is ongoing. Conclusion In this pilot service, 41 older trauma patients received CGA including falls and bone health assessment. Low falls were the leading cause of trauma, consistent with the results of the NOCA Major Trauma Audit 2021. Formal evaluation of the service is ongoing, however to date feedback has been encouraging.