Predicting postoperative delirium after microvascular decompression surgery with machine learning.
J Clin Anesth
; 66: 109896, 2020 Nov.
Article
en En
| MEDLINE
| ID: mdl-32504969
ABSTRACT
OBJECTIVE:
The aim of this study was to predict early delirium after microvascular decompression using machine learning.DESIGN:
Retrospective cohort study.SETTING:
Second Hospital of Lanzhou University. PATIENTS This study involved 912 patients with primary cranial nerve disease who had undergone microvascular decompression surgery between July 2007 and June 2018.INTERVENTIONS:
None. MEASUREMENTS We collected data on preoperative, intraoperative, and postoperative variables. Statistical analysis was conducted in R, and the model was constructed with python. The machine learning model was run using the following models decision tree, logistic regression, random forest, gbm, and GBDT models.RESULTS:
912 patients were enrolled in this study, 221 of which (24.2%) had postoperative delirium. The machine learning Gbm algorithm finds that the first five factors accounting for the weight of postoperative delirium are CBZ use duration, hgb, serum CBZ level measured 24â¯h before surgery, preoperative CBZ dose, and BUN. Through machine learning five algorithms to build prediction models, we found the following values for the training group Logistic algorithm (AUC valueâ¯=â¯0.925, accuracyâ¯=â¯0.900); Forest algorithm (AUC valueâ¯=â¯0.994, accuracyâ¯=â¯0.948); GradientBoosting algorithm (AUC valueâ¯=â¯0.994, accuracyâ¯=â¯0.970) and DecisionTree algorithm (aucvalueâ¯=â¯0.902, accuracyâ¯=â¯0.861); Gbm algorithm (AUC valueâ¯=â¯0.979, accuracyâ¯=â¯0.944). The test group had the following values Logistic algorithm (aucvalueâ¯=â¯0.920, accuracyâ¯=â¯0.901); DecisionTree algorithm (aucvalueâ¯=â¯0.888, accuracyâ¯=â¯0.883); Forest algorithm (aucvalueâ¯=â¯0.963, accuracyâ¯=â¯0.909); GradientBoostingc algorithm (aucvalueâ¯=â¯0.962, accuracyâ¯=â¯0.923); Gbm algorithm (AUC valueâ¯=â¯0.956, accuracyâ¯=â¯0.920).CONCLUSION:
Machine learning algorithms predict the occurrence of delirium after microvascular decompression with an accuracy rate of 96.7%. And the major risk factors for the development of post-cardiac delirium are carbamazepine, hgb, and BUN.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Delirio
/
Cirugía para Descompresión Microvascular
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
J Clin Anesth
Asunto de la revista:
ANESTESIOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
China