General Surgery

PROTECT: a large geriatric perioperative cohort for risk modeling

PROTECT enrolled 61,289 inpatients aged ≥65 across three tertiary centers with standardized preop, intraop, and 30‑day outcome data. Follow-up rates reached 96.5% at 48 hours and 72.1% at 30 days, supporting reliable short-term outcome capture. Common postoperative events included pulmonary infection (13.0%), nausea (11.9%), and ICU admission (8.6%); 30‑day mortality was 0.7%. The dataset already supported development and clinical implementation of predictive models for major postoperative complications. 1

EAST-BMS: an East Asian ML survival model for nonspinal bone metastasis surgery

EAST-BMS used gradient boosting on 1,045 patients from Korea, Taiwan, and Japan to predict 3‑ and 12‑month survival after nonspinal bone metastasis surgery. Temporal/dataset validation showed time‑dependent AUC ≈ 0.81 at 3 months and 0.78 at 12 months, comparable to SORG. Top predictors included albumin, KPS, lymphocyte percentage, and CRP, suggesting routine labs add prognostic value. Model performance used leave‑one‑site‑out validation but requires external prospective testing before routine clinical deployment. 2

Portal messaging rising steeply in shoulder and elbow surgical patients

In 23,643 patients, 21% sent ≥1 medical advice message; medical advice messages were 41,542 of 137,960 total messages. Message volume grew nearly 400% over the study period, and surgical patients had much higher messaging (aOR 5.93, aIRR 23.3). Black race and Spanish language were independently associated with lower odds and counts of messaging. These trends raise concerns about uncompensated provider workload and potential digital access disparities. 3