Anesthesiology

WISH system-level scores predict intent-to-leave and affective commitment across academic anesthesiology

In 1,470 health workers across 11 academic anesthesiology departments, WISH scores significantly predicted intention to leave (b = -0.45) and affective commitment (b = 0.81). Mediation analyses suggested WISH influencers sit upstream of cognitive-affective states, accounting for 53% of the ITL association and 64% of the AC association. Organizational justice scored lowest among influencers, while perceived social support and psychological safety scored highest. This multicenter psychometric validation supports using WISH to identify system-level targets to reduce turnover and improve commitment. 1

Data selection drives hypotension early-warning model performance

Using noncardiac (n=1,017) and cardiac (n=563) surgical datasets, model AUPRC changed markedly with inclusion of interventions or ongoing hypotension in evaluation data. Removing classification-altering interventions from training modestly improved AUPRC (mean difference 0.01; bootstrap P < 0.01). Filtering such interventions from evaluation increased AUPRC by ~15.5% in the cardiac set (0.54 vs 0.47). For clinically relevant early-warning evaluation, authors recommend training without interventions and testing excluding interventions and ongoing hypotension. 2

Protocol: randomized trial of nitrous oxide versus placebo for elderly THA rehabilitation pain

This protocol will randomize 160 patients aged ≥65 undergoing post-THA rehabilitation with acute pain (VAS ≥4) to nitrous oxide or placebo in a double-blind 1:1 trial. Primary outcome is pain during rehabilitation (VAS at T1), with secondary outcomes including anxiety, balance, ambulation, safety, and satisfaction. Monitoring includes continuous SpO2 and predefined stopping criteria for adverse events. Results will provide randomized evidence on nitrous oxide’s efficacy and safety for rehabilitation analgesia in older adults. 3