Predicting short-term major postoperative complications in intestinal resection for Crohn’s disease:A machine learning-based study
作者机构：Diagnostic and Treatment Center for Refractory Diseases of Abdomen SurgeryShanghai Tenth People’s HospitalTongji University School of MedicineShanghai 200072China
出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)
年 卷 期：2024年第16卷第3期
页 面：717-730页
核心收录：
学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学]
基 金：Supported by Horizontal Project of Shanghai Tenth People’s Hospital No.DS05!06!22016 and No.DS05!06!22017
主 题：Crohn’s disease Postoperative complications Nomogram Random forest Intestinal resection
摘 要：BACKGROUND Due to the complexity and numerous comorbidities associated with Crohn’s disease(CD),the incidence of postoperative complications is high,significantly impacting the recovery and prognosis of ***,additional stu-dies are required to precisely predict short-term major complications following intestinal resection(IR),aiding surgical decision-making and optimizing patient *** To construct novel models based on machine learning(ML)to predict short-term major postoperative complications in patients with CD following *** A retrospective analysis was performed on clinical data derived from a patient cohort that underwent IR for CD from January 2017 to December *** study participants were randomly allocated to either a training cohort or a validation *** logistic regression and random forest(RF)were applied to construct models in the training cohort,with model discrimination evaluated using the area under the curves(AUC).The validation cohort assessed the performance of the constructed *** Out of the 259 patients encompassed in the study,5.0%encountered major postoperative complications(Clavien-Dindo≥III)within 30 d following IR for *** AUC for the logistic model was 0.916,significantly lower than the AUC of 0.965 for the RF *** logistic model incorporated a preoperative CD activity index(CDAI)of≥220,a diminished preoperative serum albumin level,conversion to laparotomy surgery,and an extended operation time.A nomogram for the logistic model was *** for the surgical approach,the other three variables ranked among the top four important variables in the novel ML *** Both the nomogram and RF exhibited good performance in predicting short-term major postoperative complic-ations in patients with CD,with the RF model showing more superiority.A preoperative CDAI of≥220,a di-minished preoperative serum albumin level,and an extended operation time might be the most crucial ***
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