| Autor: |
Yifeng Chen, Xiaoyu Cai, Zicheng Cao, Jie Lin, Wenyu Huang, Yuan Zhuang, Lehan Xiao, Xiaozhen Guan, Ying Wang, Xingqiu Xia, Feng Jiao, Xiangjun Du, Guozhi Jiang, Deqing Wang |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Frontiers in Surgery, Vol 10 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2296-875X |
| DOI: |
10.3389/fsurg.2023.1047558 |
| Popis: |
ObjectivePostoperative red blood cell (RBC) transfusion is widely used during the perioperative period but is often associated with a high risk of infection and complications. However, prediction models for RBC transfusion in patients with orthopedic surgery have not yet been developed. We aimed to identify predictors and constructed prediction models for RBC transfusion after orthopedic surgery using interpretable machine learning algorithms.MethodsThis retrospective cohort study reviewed a total of 59,605 patients undergoing orthopedic surgery from June 2013 to January 2019 across 7 tertiary hospitals in China. Patients were randomly split into training (80%) and test subsets (20%). The feature selection method of recursive feature elimination (RFE) was used to identify an optimal feature subset from thirty preoperative variables, and six machine learning algorithms were applied to develop prediction models. The Shapley Additive exPlanations (SHAP) value was employed to evaluate the contribution of each predictor towards the prediction of postoperative RBC transfusion. For simplicity of the clinical utility, a risk score system was further established using the top risk factors identified by machine learning models.ResultsOf the 59,605 patients with orthopedic surgery, 19,921 (33.40%) underwent postoperative RBC transfusion. The CatBoost model exhibited an AUC of 0.831 (95% CI: 0.824–0.836) on the test subset, which significantly outperformed five other prediction models. The risk of RBC transfusion was associated with old age (>60 years) and low RBC count ( |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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