Predicting early return to the operating room in early-onset scoliosis patients using machine learning techniques.
Spine Deform
; 12(4): 1165-1172, 2024 Jul.
Article
en En
| MEDLINE
| ID: mdl-38530612
ABSTRACT
PURPOSE:
Surgical treatment of early-onset scoliosis (EOS) is associated with high rates of complications, often requiring unplanned return to the operating room (UPROR). The aim of this study was to create and validate a machine learning model to predict which EOS patients will go on to require an UPROR during their treatment course.METHODS:
A retrospective review was performed of all surgical EOS patients with at least 2 years follow-up. Patients were stratified based on whether they had experienced an UPROR. Ten machine learning algorithms were trained using tenfold cross-validation on an independent training set of patients. Model performance was evaluated on a separate testing set via their area under the receiver operating characteristic curve (AUC). Relative feature importance was calculated for the top-performing model.RESULTS:
257 patients were included in the study. 146 patients experienced at least one UPROR (57%). Five factors were identified as significant and included in model training age at initial surgery, EOS etiology, initial construct type, and weight and height at initial surgery. The Gaussian naïve Bayes model demonstrated the best performance on the testing set (AUC 0.79). Significant protective factors against experiencing an UPROR were weight at initial surgery, idiopathic etiology, initial definitive fusion construct, and height at initial surgery.CONCLUSIONS:
The Gaussian naïve Bayes machine learning algorithm demonstrated the best performance for predicting UPROR in EOS patients. Heavier, taller, idiopathic patients with initial definitive fusion constructs experienced UPROR less frequently. This model can be used to better quantify risk, optimize patient factors, and choose surgical constructs. LEVEL OF EVIDENCE Prognostic III.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Escoliosis
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Aprendizaje Automático
Límite:
Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Revista:
Spine Deform
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos