New model predicts sedation score changes after elective orthopedic surgery

A large retrospective study in GeroScience reports a preoperative prediction model for neurobehavioral instability after elective orthopedic surgery, using only routinely collected demographics and blood-test data. The research screened 46,804 consecutive procedures at a tertiary hospital in Spain from 2018 to 2024; after eligibility criteria, 41,010 patients formed the analytical cohort. Of them, 377 experienced postoperative changes on the Richmond Agitation-Sedation Scale (RASS), creating a class-imbalance challenge. The model’s key feature is temporal validation: patients treated earlier (34,271) were used to build it, while the most recent 6,739 formed an independent holdout set, improving resistance to overfitting.