Prediction of massive bleeding in pancreatic surgery based on preoperative patient characteristics using a decision tree.
Prediction of massive bleeding in pancreatic surgery based on preoperative patient characteristics using a decision tree.
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DOI：
10.1371/journal.pone.0259682
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Hakamada K
中科院分区：
文献类型：
--
作者：
Wakiya T;Ishido K;Kimura N;Nagase H;Kubota S;Fujita H;Hagiwara Y;Kanda T;Matsuzaka M;Sasaki Y;Hakamada K
术中大量失血 (IBL) 对胰腺导管腺癌 (PDAC) 术后的结果产生负面影响。然而，很少有数据或预测模型可用于识别大规模 IBL 高风险患者。本研究旨在使用决策树算法（一种机器学习方法）构建大规模 IBL 预测模型。 2007 年 1 月至 2020 年 10 月期间，175 名在我们的机构接受可切除 PDAC 根治性手术的患者被分配到训练组 (n = 128) 和测试组 (n = 47)。利用患者术前可用的数据（34 个变量），我们构建了决策树分类算法。在 175 名患者中，88 名患者（50.3%）发生大量 IBL。二元Logistic回归分析表明，丙氨酸转氨酶和远端胰腺切除术是大量IBL发生的显着预测因素，总体正确预测率为70.3%。决策树分析自动选择 14 个预测变量。最好的预测因素是外科手术。尽管大量 IBL 并不常见，但远端胰腺切除术患者的结果其次是谷氨酰转肽酶。在接受 PD 的患者 (n = 83) 中，选择糖尿病 (DM) 作为第二次分组的变量。 21例DM患者中，85.7%发生大量IBL。决策树敏感性在训练数据集中为 98.5%，在测试数据集中为 100%。我们的研究结果表明，决策树可以提供一种新的潜在方法来预测可切除 PDAC 手术中的大量 IBL。
Massive intraoperative blood loss (IBL) negatively influence outcomes after surgery for pancreatic ductal adenocarcinoma (PDAC). However, few data or predictive models are available for the identification of patients with a high risk for massive IBL. This study aimed to build a model for massive IBL prediction using a decision tree algorithm, which is one machine learning method. One hundred and seventy-five patients undergoing curative surgery for resectable PDAC at our facility between January 2007 and October 2020 were allocated to training (n = 128) and testing (n = 47) sets. Using the preoperatively available data of the patients (34 variables), we built a decision tree classification algorithm. Of the 175 patients, massive IBL occurred in 88 patients (50.3%). Binary logistic regression analysis indicated that alanine aminotransferase and distal pancreatectomy were significant predictors of massive IBL occurrence with an overall correct prediction rate of 70.3%. Decision tree analysis automatically selected 14 predictive variables. The best predictor was the surgical procedure. Though massive IBL was not common, the outcome of patients with distal pancreatectomy was secondarily split by glutamyl transpeptidase. Among patients who underwent PD (n = 83), diabetes mellitus (DM) was selected as the variable in the second split. Of the 21 patients with DM, massive IBL occurred in 85.7%. Decision tree sensitivity was 98.5% in the training data set and 100% in the testing data set. Our findings suggested that a decision tree can provide a new potential approach to predict massive IBL in surgery for resectable PDAC.
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影响因子：
2.5
作者：
Doi, Ryuichiro;Imamura, Masayuki;Yoshida, Shigeaki
通讯作者：
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DOI：
10.1016/j.jamcollsurg.2012.09.002
发表时间：
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影响因子：
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