Anesthesiology

PROTECT: large multicenter geriatric perioperative cohort enabling risk models

PROTECT enrolled 61,289 inpatients aged 65–100 across three tertiary centers with standardized perioperative data collection. Follow-up rates reached 96.5% at 48 hours and 72.1% at 30 days, enabling reliable short-term outcome ascertainment. Observed 30-day all-cause mortality was 0.7% and common complications included pulmonary infection (13.0%) and ICU admission (8.6%). The dataset has already supported prediction-model development and can inform geriatric risk stratification and shared decision-making. 1

EHR clinical decision support reduced oxycodone MME at surgical discharge

A system-wide real-time CDS lowered per-discharge oxycodone from 27.4 to 16.5 MME (level ratio 0.83, P<0.001). The proportion of discharges receiving any oxycodone fell from 21% to 18% (relative risk 0.87). Among those prescribed opioids, median MME decreased from 112 to 75 MME after the intervention. Interrupted time series showed an immediate level change but no change in slope, suggesting sustained stepwise improvement. 2

Predictors of local anaesthesia failure during non-surgical root canal treatment

In 1,723 patients, intraoperative local anaesthesia failure occurred in 16% of non-surgical root canal treatments. Independent risk factors included age <55 years, reported dental fear, mandibular tooth location, and multiple abnormal pre-op tests. Treatment by an endodontist was associated with lower failure rates after adjustment. Preoperative pain sensitivity correlated with greater intraoperative pain reported. 3