A5038861501- Frailty in Older Adults
- Cardiac, Anesthesia and Surgical Outcomes
- Hip and Femur Fractures
- Trauma and Emergency Care Studies
- COVID-19 Clinical Research Studies
- COVID-19 and healthcare impacts
- Long-Term Effects of COVID-19
- Geriatric Care and Nursing Homes
- Pelvic and Acetabular Injuries
- Healthcare cost, quality, practices
- Neurosurgical Procedures and Complications
- Intracerebral and Subarachnoid Hemorrhage Research
- Chronic Disease Management Strategies
- Trauma Management and Diagnosis
- Traumatic Brain Injury and Neurovascular Disturbances
- Nutrition and Health in Aging
- Intensive Care Unit Cognitive Disorders
- COVID-19 and Mental Health
- Health Systems, Economic Evaluations, Quality of Life
- Enhanced Recovery After Surgery
- Surgical Simulation and Training
- Clinical practice guidelines implementation
- Palliative Care and End-of-Life Issues
- Family and Patient Care in Intensive Care Units
- Airway Management and Intubation Techniques
At Bristol
2025
North Bristol NHS Trust
2020-2025
University of the West of England
2021-2025
Manning Diversified Forest Products (Canada)
2025
Southmead Hospital
2020-2023
Guy's and St Thomas' NHS Foundation Trust
2016-2019
St Thomas' Hospital
2015-2017
Imperial College Healthcare NHS Trust
2010
Abstract Background C-reactive protein (CRP) is a non-specific acute phase reactant elevated in infection or inflammation. Higher levels indicate more severe and have been used as an indicator of COVID-19 disease severity. However, the evidence for CRP prognostic marker yet to be determined. The aim this study examine response patients hospitalized with determine utility on admission predicting inpatient mortality. Methods Data were collected between 27 February 10 June 2020, incorporating...
Background: To inform clinical practice and policy, it is essential to understand the lived experience of health social care policies, including restricted visitation policies towards end life. Aim: explore views experiences Twitter media users who reported that a relative, friend or acquaintance died COVID-19 without family member/friend present. Design: Qualitative content analysis English-language tweets. Data sources: data collected 7–20th April 2020. A bespoke software system harvested...
To assess the impact of introducing and embedding a structured geriatric liaison service, Proactive care Older People undergoing Surgery (POPS)-Urology, using comprehensive assessment methodology, on an inpatient urology ward.A phased quality improvement project was undertaken stepwise interventions. Phase 1 before-and-after study with initiation daily board round, weekly multidisciplinary meeting, targeted geriatrician-led ward rounds for elective emergency patients aged ≥65 years admitted...
Coronavirus disease 2019 (COVID-19) infection causes acute lung injury, resulting from aggressive inflammation initiated by viral replication. There has been much speculation about the potential role of non-steroidal inflammatory drugs (NSAIDs), which increase expression angiotensin-converting enzyme 2 (ACE2), a binding target for severe respiratory syndrome coronavirus (SARS-CoV-2) to enter host cell, could lead poorer outcomes in COVID-19 disease. The aim this study was examine association...
Background: geriatrics encompasses diverse medical, social and ethical challenges requiring a multidimensional, interdisciplinary approach. Recent reports have highlighted failings in the care of older people. It is therefore vital that trainees are afforded opportunities to develop skills managing this complex population. Simulation has been adopted as teaching tool medicine; however, evidence for its use limited small, single-site studies primarily involving role-play or discrete clinical...
Frailty assessment using the Clinical Scale (CFS) has been mandated for older people admitted to English major trauma centres (MTC) since April 2019. Little evidence is available as CFS-associated outcomes in population.To investigate post-injury stratified by CFS.A single centre prospective observational cohort study was undertaken. CFS prospectively assigned patients ≥ 65 years old MTC over a 5-month period. Primary outcome 30-day mortality. Secondary were length of hospital stay,...
BackgroundOlder people are the largest group admitted to hospital with serious injuries. Many older living frailty, a risk factor for poor recovery. We aimed examine effect of preinjury frailty on outcomes.MethodsIn this multicentre observational study (FiTR 1), we extracted prospectively collected data from all 23 adult major trauma centres in England (aged ≥65 years) injuries over 2·5 year period Trauma Audit and Research Network (TARN) database. Geriatricians assessed Clinical Frailty...
BackgroundOlder people are at the greatest risk of poor outcomes after serious injury. Evidence is limited for benefit assessment by a geriatrician in trauma care. We aimed to determine effect on clinical older admitted hospital with injury.MethodsIn this multicentre observational study (FiTR 2), we extracted prospectively collected data (aged ≥65 years) 23 major centres England over 2·5 year period from Trauma Audit and Research Network (TARN) database. examined within 72 h admission...
During the COVID-19 pandemic continuation or cessation of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) has been contentious. Mechanisms have proposed for both beneficial detrimental effects. Recent studies focused on mortality with no literature having examined length hospital stay. The aim this study was to determine influence ACEi ARBs stay.COPE (COVID-19 in Older People) is a multicenter observational including adults all ages admitted either...
Background Lidocaine patches, applied over rib fractures, may reduce pulmonary complications in older patients. Known barriers to recruiting patients emergency settings necessitate a feasibility trial. We aimed establish whether definitive randomised controlled trial (RCT) evaluating lidocaine patches with fracture(s) was feasible. Methods This multicentre, parallel-group, open-label, RCT seven hospitals England and Scotland. Patients aged ≥65 years, presenting ED traumatic requiring...
The COVID-19 pandemic has placed significant pressure on health and social care. Survivors of may be left with substantial functional deficits requiring ongoing We aimed to determine whether pre-admission frailty was associated increased care needs at discharge for patients admitted hospital COVID-19.Patients were included if aged over 18 years old between 27 February 10 June 2020. Clinical Frailty Scale (CFS) used assess status. Admission levels recorded. Data analysed using a mixed-effects...
Abstract Background Effective shielding measures and virus mutations have progressively modified the disease between waves, likewise healthcare systems adapted to outbreak. Our aim was compare clinical outcomes for older people with COVID-19 in Wave 1 (W1) 2 (W2). Methods All data, including Clinical Frailty Scale (CFS), were collected consecutive patients, aged ≥65, from 13 hospitals, W1 (February–June 2020) W2 (October 2020–March 2021). The primary outcome mortality (time 28-day...
This protocol describes an observational study which set out to assess whether frailty and/or multimorbidity correlates with short-term and medium-term outcomes in patients diagnosed COVID-19 a European, multicentre setting.Over 3-month period we aim recruit minimum of 500 across 10 hospital sites, collecting baseline data including: patient demographics; presence comorbidities; relevant blood tests on admission; prescription ACE inhibitors/angiotensin receptor blockers/non-steroidal...
Abstract Background the Geriatric Perioperative Care clinic at North Bristol NHS Trust was suspended in March 2020 during COVID-19 pandemic. A virtual piloted to deliver preoperative health optimisation and shared decision-making for patients undergoing critical elective surgery. No literature existed on clinics older people support development. Objective this healthcare improvement study describes setup delivery of as its primary aim. Secondary aims included: assessing people’s access...
Abstract Background The international scale and spread of evidence-based perioperative medicine for older people undergoing surgery (POPS) services has not yet been fully realised. Implementation science provides a structured approach to understanding factors that act as barriers facilitators the implementation POPS services. In this study, we aimed identify influence in UK. Methods A qualitative case study at three UK health was undertaken. differed across contextual (population, workforce,...
Frailty is known to affect how people admitted with traumatic injuries recover during their inpatient stay and shortly after discharge. However, few studies have examined the effect of frailty on long-term mortality when adjusted for significant factors including age. We aimed determine 1-year morality in older adults injuries.We undertook an observational study at Severn Major Trauma Network's major trauma centre based South West England. Patients ≥65 years old between November 2018...
Abstract Background The reduced renal function has prognostic significance in COVID-19 and it been linked to mortality the general population. Reduced is prevalent older age thus we set out better understand its effect on mortality. Methods Patient clinical demographic data was taken from Older People (COPE) study during two periods (February–June 2020 October 2020–March 2021, respectively). Kidney admission measured using estimated glomerular filtration rate (eGFR). primary outcomes were...