Data Driven Approaches to Improving Risk Prediction of Pulmonary Complications After Major Inpatient Surgery

数据驱动的方法改善重大住院手术后肺部并发症的风险预测

• 批准号: 10665631
• 负责人: Douglas Alastair Colquhoun
• 金额: $ 16.58万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10665631
• 关键词: Acute Renal Failure with Renal Papillary Necrosis; Address; Affect; Anesthesia procedures; Anesthesiology; Board Certification; Caring; Clinical; Communication; Competence; Complex; Complication; Computer software; Computerized Medical Record; Consent; Critical Care; Data; Data Science; Decision Making; Derivation procedure; Development; Electronic Health Record; Elements; Event; Evidence based intervention; Goals; Grant; Hospital Costs; Hospitals; Hypoxemia; Induction of neuromuscular blockade; Information Systems; Inpatients; Institution; International; Intervention; Intraoperative Care; Intraoperative Period; Intubation; Knowledge; Learning; Length of Stay; Life; Light; Liquid substance; Lung; Machine Learning; Mechanical ventilation; Medicine; Mentors; Michigan; Modernization; Monitor; Morbidity - disease rate; Myocardial Infarction; Observational Study; Operating Rooms; Operative Surgical Procedures; Opioid; Outcome; Patient Care; Patient risk; Patients; Patterns of Care; Perioperative; Perioperative Care; Physiological; Physiology; Pneumonia; Population; Postoperative Complications; Postoperative Period; Preoperative Procedure; Prevention; Private Hospitals; Procedures; Process; Provider; Recording of previous events; Records; Registries; Reporting; Research; Research Personnel; Research Training; Resources; Risk; Risk Estimate; Risk Factors; Risk Reduction; Scientist; Series; Site; Statistical Models; Structure; Surgical complication; Techniques; Time; Training; Transfusion; Translating; Universities; Update; Variant; Ventilator; Work; career; career development; clinical practice; clinically relevant; cohort; cost; data complexity; data modeling; data streams; evidence base; high dimensionality; high risk; improved; individual patient; innovation; inpatient surgery; insight; interoperability; minimally invasive; mortality; myocardial injury; patient registry; patient response; point of care; predictive tools; prevent; professor; risk prediction; risk prediction model; skills; supervised learning; tenure track; vigilance

ABSTRACT BACKGROUND: Postoperative pulmonary complications (PPCs) are common and major drivers of morbidity and mortality after major inpatient surgery. Various risk prediction scores identify patients at high risk of developing PPCs and observational research has connected peri-operative care practices with subsequent risk. However, anesthesia providers do not have patient specific evidence based interventions to prevent pulmonary complications. RESEARCH: The proposed research will draw on a wealth of perioperative information available to identify the interactions of patient, procedure and process of care factors which place patients at risk of PPCs. This will incorporate advances in data science to the pre-operative prediction of PPCs (Aim 1). We will then revise and improve this estimate in light of the high fidelity intraoperative data stream from ventilators, monitors and patient response to real life decisions being made during the delivery of anesthesia care (Aim 2). This will allow understanding of what features most contributed to patient specific risk (Aim 3). The proposed research and training will provide Dr Colquhoun with the skills in data science to his transition to an independent researcher. CANDIDATE: Dr Douglas A Colquhoun is a tenure track Assistant Professor of Anesthesiology at the University of Michigan. He is board certified in Anesthesiology and Critical Care Medicine and maintains an active clinical practice in the perioperative care of patients undergoing major surgery. During a T32 Research Training Grant, Dr Colquhoun developed expertise in the derivation of outcomes and processes of care from electronic medical record data. His long term career goal is to prevent postoperative pulmonary complications by offering anesthesia providers data driven strategies for management delivered at the point of care. ENVIRONMENT: The University of Michigan is the coordinating center for the Multicenter Perioperative Outcomes Group (MPOG) an international consortium of 50 anesthesiology and surgical departments with perioperative information systems. Sachin Kheterpal, MD, MBA is the primary mentor for Dr. Colquhoun, and is the Director for MPOG. Dr Kheterpal and the Department of Anesthesiology have a rich history of developing and deploying innovative software solutions to address problems in perioperative medicine and research. Dr Colquhoun will additionally be advised from expert co-mentors drawn from across the institution and a scientific advisory panel expert in the prevention and management of postoperative complications.

摘要

项目成果

Automated Detection of Postoperative Reintubation Using Electronic Health Record Data.

使用电子健康记录数据自动检测术后重新插管。

• DOI: 10.1097/aln.0000000000004796
• 发表时间: 2024
• 期刊: Anesthesiology
• 影响因子: 8.8
• 作者: Saad,Manal;Dubovoy,TimurZ;Kheterpal,Sachin;Colquhoun,DouglasA
• 通讯作者: Colquhoun,DouglasA

Variability in Intraoperative Opioid and Nonopioid Utilization During Intracranial Surgery: A Multicenter, Retrospective Cohort Study.

颅内手术期间阿片类药物和非阿片类药物使用的变异性：一项多中心、回顾性队列研究。

• DOI: 10.1097/ana.0000000000000960
• 发表时间: 2024
• 期刊: Journal of neurosurgical anesthesiology
• 影响因子: 3.7
• 作者: Naik,BhikenI;Lele,AbhijitV;Sharma,Deepak;Akkermans,Annemarie;Vlisides,PhillipE;Colquhoun,DouglasA;Domino,KarenB;Tsang,Siny;Sun,Eric;Dunn,LaurenK;MulticenterPerioperativeOutcomesCollaboratorGroup
• 通讯作者: MulticenterPerioperativeOutcomesCollaboratorGroup

Feasibility pilot trial for the Trajectories of Recovery after Intravenous propofol versus inhaled VolatilE anesthesia (THRIVE) pragmatic randomised controlled trial.

• DOI: 10.1136/bmjopen-2022-070096
• 发表时间: 2023-04-17
• 期刊: BMJ OPEN
• 影响因子: 2.9
• 作者: Tellor Pennington, Bethany R.;Colquhoun, Douglas A.;Neuman, Mark D.;Politi, Mary C.;Janda, Allison M.;Spino, Cathie;Thelen-Perry, Steven;Wu, Zhenke;Kumar, Sathish S.;Gregory, Stephen H.;Avidan, Michael S.;Kheterpal, Sachin
• 通讯作者: Kheterpal, Sachin

A retrospective observational cross-sectional study of intraoperative neuromuscular blocking agent choice and dosing in a US paediatric referral hospital before and after introduction of sugammadex☆.

美国一家儿科转诊医院在引入舒更葡糖前后进行的一项关于术中神经肌肉阻滞剂选择和剂量的回顾性观察横断面研究。

• DOI: 10.1016/j.bja.2023.07.013
• 发表时间: 2023
• 期刊: British journal of anaesthesia
• 影响因子: 9.8
• 作者: Brown,SydneyES;Spellman,Kevin;Cassidy,Ruth;Nause-Osthoff,Rebecca;Bailey,Meridith;Mentz,Graciela;Wagner,Deborah;Haydar,Bishr;Chimbira,Wilson;Kheterpal,Sachin;Colquhoun,Douglas
• 通讯作者: Colquhoun,Douglas

Carbon Dioxide, Blood Pressure, and Perioperative Stroke: A Retrospective Case-Control Study.

• DOI: 10.1097/aln.0000000000004354
• 发表时间: 2022-10-01
• 期刊: Anesthesiology
• 影响因子: 8.8