Rajni Lal

@GongGasGirl That’s a winner! LoveSydney

Sydney. No Filter.

⏱️ Time to surgery matters — and this study proves it. In Chile’s public health system, a new protocol for immediate admission to surgical hospitals after a hip fracture cut time to surgery by 5 days. Why does that matter? 🔹 Faster surgery = less time spent in hospital beds 🔹 21% drop in total hospital stay 🔹 70% reduction in direct hospital costs 🔹 Fewer risky transfers between hospitals By prioritising fast-track surgical care and recovery times, overall patient outcomes can be significantly improved. 🔗 Read more: doi.org/10.1016/j.tjfa… #ANZHFR #HipFractureCare

Infographic on #delirium prevention and management from the American College of Chest Physicians

Deprescribing of sedatives was associated with a 62% reduction in odds of an adverse drug event, whereas new sedative use at discharge was associated with an increased risk of falls. #geriatrics agsjournals.onlinelibrary.wiley.com/doi/10.1111/jg…

At our CPOC Advisory Group Webinar CPOC Deputy Director @scarlettmcnally reinforces the clear evidence for perioperative care. ➡️Preoperative optimisation reduces complications by up 50% ➡️ 3% of patients account for 45% of hospital costs ➡️12% of operations have complications

Frailty Matters—Why Isn't It Guiding Clinical Decisions? #geriatrics agsjournals.onlinelibrary.wiley.com/doi/10.1111/jg…

New Research: Delirium in Hip Fracture Patients Associated with Doubled Mortality Risk I'm pleased to share our new study on delirium and hip fracture, led by @rosespenfold. 91% of all hip fracture patients attending Scottish hospitals had a 4AT delirium assessment tool performed at presentation (N=16,476 ). N=3,386 (21%) had delirium. Key findings: - Delirium was associated with important adverse outcomes including 2-fold higher mortality risks as an inpatient and at one year, and a lower likelihood of returning home following hospital admission. Key implications: - Delirium assessment on initial presentation is feasible at national scale. - Delirium assessment should be performed on presentation of hip fracture. - Hip fracture care without delirium assessment is deficient care. ***Background*** Previous studies have focused primarily on postoperative delirium. This is the first large scale study using routine data to examine delirium ascertained directly with a real-time clinical assessment at the time of hospital admission. ***Methods*** We analysed data from the Scottish Hip Fracture Audit, which covers over 99% of people aged 50+ years hospitalized with acute hip fracture in Scotland. Delirium assessment: 4AT (the4AT.com), which is embedded into routine care and performed by clinical staff. ***Results*** Delirium was present 21% of patients. Patients with delirium were older (mean age 85 vs. 78 years), more likely to be in care homes, and had higher ASA grades. After adjusting for age, sex, pre-fracture residence, and ASA grade, patients with delirium had a 2-fold increased risk of inpatient mortality (adjusted OR 2.26, 95% CI 1.79 to 2.84).The same pattern was observed for one-year mortality (adjusted OR 2.05, 95% CI 1.83 to 2.29). Patients with delirium were less likely to return to their original residence within 30 days (adjusted OR 0.27, 95% CI 0.24 to 0.30) ***Conclusions*** Delirium at hip fracture presentation is a powerful prognostic indicator that can inform shared decision-making with patients and families. Identifying delirium early allows clinicians to address potentially reversible causes and implement appropriate management strategies. Recognition of delirium can help in planning post-acute care needs. Another crucial implication is that we have definitively demonstrated that delirium testing using a validated tool is *feasible in routine practice* in this population. Hip fracture patients must have delirium assessments, and these must be done pre-operatively as well as post-operatively. ***Call to action*** Let's move forward and make good delirium care the norm in hip fracture patients. Let's make system-wide groupthink that it is okay to neglect delirium a thing of the past. Study: boneandjoint.org.uk/article/10.130… #delirium #hipfracture

Big day today!! Our @NIHR_ARC_YH eFI2 study published in @Age_and_Ageing academic.oup.com/ageing/article… National implementation will support proactive care for older people to maximise independence leeds.ac.uk/main-index/new… Fab team @AUASResearch @CAPS_UCL @LeedsBRC @HDR_UK @GeriSoc

The national rollout of specialist frailty services across all 30 of Scotland’s A&E departments is set to reduce the length of hospital stays and eventually bring down waiting lists, says Scotland’s Health Secretary. @neilcgray @NHSResearchScot @RCollEM healthandcare.scot/stories/4087/n…

@MagdaSbai @GSTTnhs @POPS_GSTT Love this. All the best to @POPS_GSTT hope you win…totally deserve it.

Amazing that the POPS team @GSTTnhs have been shortlisted for outstanding contribution by a team or department at The Medical Educators Award 2025! Transdisciplinary quality education is a lynchpin in improving the care of older surgical patients. @POPS_GSTT

👏🏼

Maybe you want to know more about our #siptilsend journey! Have a look at our 5 W’s! 🌍💙

@drandyclegg @NIHRresearch @LeedsMedHealth @BTHFT @NIHR_ARC_YH @HDR_UK Amazing. Well done.

Absolutely delighted to be awarded an @NIHRresearch Professorship focusing on maximising independence for older people. Huge thanks to @LeedsMedHealth, @BTHFT, UK and international colleagues for their amazing support! Exciting times! medicinehealth.leeds.ac.uk/faculty-/news/… @NIHR_ARC_YH @HDR_UK

Perfect! We don’t have to create our own now! Thanks so much. 💪🏽 #Prehab

What an amazing week for our Periop Team @Blacktown Hosp. Team work. 💪🏽🌟 @PuneetRanote @WestSydHealth @SipTilSend @ANZCA @anzsgm_poc @DrDanetteW #Frailty#SDM @RACSurgeons @jenhelenmar

DOACs can be safely interrupted for elective procedures without bridging. Don’t forget to resume them post-procedure! #PeriSIG24 @ANZCA @jdfvan6

The ANZCA POM SIG kicks off tomorrow in Melb! 🚀 Incredible speakers, global insights, and big ideas to elevate periop care. Ready to be inspired! 💪🏽😎#PeriSIG24 #SDM @ANZCA @CPOC_News @anzsgm_poc @WestSydHealth @isdmsociety @PeriOpQI @DrDanetteW @jdfvan6

Listening to ⁦@RachelMAitken⁩ talk about TOPS. Fantastic work being done at RMH. ⁦@anzsgm_poc⁩ ⁦

Frailty impacts healthcare use and costs. Can we improve support and care in the community and in hospital? 🔗 Discover the latest research on this topic: evidence.nihr.ac.uk/collection/fra… @sheffielddoc @steesdementia @brunning_adam #NIHRevidence