Ensemble learning-assisted prediction of prolonged hospital length of stay after spine correction surgery : a multi-center cohort study

© 2024. The Author(s)..

PURPOSE: This research aimed to develop a machine learning model to predict the potential risk of prolonged length of stay in hospital before operation, which can be used to strengthen patient management.

METHODS: Patients who underwent posterior spinal deformity surgery (PSDS) from eleven medical institutions in China between 2015 and 2022 were included. Detailed preoperative patient data, including demographics, medical history, comorbidities, preoperative laboratory results, and surgery details, were collected from their electronic medical records. The cohort was randomly divided into a training dataset and a validation dataset with a ratio of 70:30. Based on Boruta algorithm, nine different machine learning algorithms and a stack ensemble model were trained after hyperparameters tuning visualization and evaluated on the area under the receiver operating characteristic curve (AUROC), precision-recall curve, calibration, and decision curve analysis. Visualization of Shapley Additive exPlanations method finally contributed to explaining model prediction.

RESULTS: Of the 162 included patients, the K Nearest Neighbors algorithm performed the best in the validation group compared with other machine learning models (yielding an AUROC of 0.8191 and PRAUC of 0.6175). The top five contributing variables were the preoperative hemoglobin, height, body mass index, age, and preoperative white blood cells. A web-based calculator was further developed to improve the predictive model's clinical operability.

CONCLUSIONS: Our study established and validated a clinical predictive model for prolonged postoperative hospitalization duration in patients who underwent PSDS, which offered valuable prognostic information for preoperative planning and postoperative care for clinicians. Trial registration ClinicalTrials.gov identifier NCT05867732, retrospectively registered May 22, 2023, https://classic.

CLINICALTRIALS: gov/ct2/show/NCT05867732.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:19

Enthalten in:

Journal of orthopaedic surgery and research - 19(2024), 1 vom: 02. Feb., Seite 112

Sprache:

Englisch

Beteiligte Personen:

Li, Wenle [VerfasserIn]
Zhang, Yusi [VerfasserIn]
Zhou, Xin [VerfasserIn]
Quan, Xubin [VerfasserIn]
Chen, Binghao [VerfasserIn]
Hou, Xuewen [VerfasserIn]
Xu, Qizhong [VerfasserIn]
He, Weiheng [VerfasserIn]
Chen, Liang [VerfasserIn]
Liu, Xiaozhu [VerfasserIn]
Zhang, Yang [VerfasserIn]
Xiang, Tianyu [VerfasserIn]
Li, Runmin [VerfasserIn]
Liu, Qiang [VerfasserIn]
Wu, Shi-Nan [VerfasserIn]
Wang, Kai [VerfasserIn]
Liu, Wencai [VerfasserIn]
Zheng, Jialiang [VerfasserIn]
Luan, Haopeng [VerfasserIn]
Yu, Xiaolin [VerfasserIn]
Chen, Anfa [VerfasserIn]
Xu, Chan [VerfasserIn]
Luo, Tongqing [VerfasserIn]
Hu, Zhaohui [VerfasserIn]

Links:

Volltext

Themen:

Clinical Study
Journal Article
Machine learning
Multicenter Study
Multimodal
Posterior spinal deformity surgery
Postoperative length of stay
Spinal deformity

Anmerkungen:

Date Completed 12.02.2024

Date Revised 12.02.2024

published: Electronic

ClinicalTrials.gov: NCT05867732

Citation Status MEDLINE

doi:

10.1186/s13018-024-04576-4

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM367977168