Barbara Frezza, Mario Cesare Nurchis, Gabriella Teresa Capolupo, Filippo Carannante, Marco De Prizio, Fabio Rondelli, Danilo Alunni Fegatelli, Alessio Gili, Luca Lepre, Gianluca Costa
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引用次数: 0
摘要
老年人群的虚弱与对压力源(包括手术干预)的脆弱性增加有关。本研究将机器学习(ML)模型与临床床边工具胃肠道手术虚弱指数(GiS-FI)进行比较,以预测接受胃肠道癌症手术的老年患者的死亡率和发病率。在一项937例年龄≥65岁的患者的多中心分析中,评估了各种预测模型的性能,包括随机森林(RF)、最小绝对收缩和选择算子(LASSO)、逐步回归、k近邻、神经网络和支持向量机算法。总的30天死亡率和发病率分别为6.1%和35.7%。在死亡率预测方面,RF模型的AUC为0.822 (95% CI 0.714-0.931),优于GiS-FI评分(AUC = 0.772, 95% CI 0.675-0.868)。对于发病率预测,所有模型均表现出较弱的辨别能力,其中逐步回归和LASSO回归表现最好(auc分别为0.652和0.647)。我们的研究结果表明,与传统的临床评分相比,ML方法,特别是RF算法,在进行胃肠手术的老年癌症患者的死亡风险评估中提供了更高的预测准确性。这些先进的分析工具可以为这些弱势人群的手术风险分层提供有价值的决策支持。
A Comparison of Machine Learning-Based Models and a Simple Clinical Bedside Tool to Predict Morbidity and Mortality After Gastrointestinal Cancer Surgery in the Elderly.
Frailty in the elderly population is associated with increased vulnerability to stressors, including surgical interventions. This study compared machine learning (ML) models with a clinical bedside tool, the Gastrointestinal Surgery Frailty Index (GiS-FI), for predicting mortality and morbidity in elderly patients undergoing gastrointestinal cancer surgery. In a multicenter analysis of 937 patients aged ≥65 years, the performance of various predictive models including Random Forest (RF), Least Absolute Shrinkage and Selection Operator (LASSO), Stepwise Regression, K-Nearest Neighbors, Neural Network, and Support Vector Machine algorithms were evaluated. The overall 30-day mortality and morbidity rates were 6.1% and 35.7%, respectively. For mortality prediction, the RF model demonstrated superior performance with an AUC of 0.822 (95% CI 0.714-0.931), outperforming the GiS-FI score (AUC = 0.772, 95% CI 0.675-0.868). For morbidity prediction, all models showed more modest discrimination, with stepwise regression and LASSO regression achieving the highest performance (AUCs of 0.652 and 0.647, respectively). Our findings suggest that ML approaches, particularly RF algorithm, offer enhanced predictive accuracy compared to traditional clinical scores for mortality risk assessment in elderly cancer patients undergoing gastrointestinal surgery. These advanced analytical tools could provide valuable decision support for surgical risk stratification in this vulnerable population.
期刊介绍:
Aims
Bioengineering (ISSN 2306-5354) provides an advanced forum for the science and technology of bioengineering. It publishes original research papers, comprehensive reviews, communications and case reports. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. All aspects of bioengineering are welcomed from theoretical concepts to education and applications. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced. There are, in addition, four key features of this Journal:
● We are introducing a new concept in scientific and technical publications “The Translational Case Report in Bioengineering”. It is a descriptive explanatory analysis of a transformative or translational event. Understanding that the goal of bioengineering scholarship is to advance towards a transformative or clinical solution to an identified transformative/clinical need, the translational case report is used to explore causation in order to find underlying principles that may guide other similar transformative/translational undertakings.
● Manuscripts regarding research proposals and research ideas will be particularly welcomed.
● Electronic files and software regarding the full details of the calculation and experimental procedure, if unable to be published in a normal way, can be deposited as supplementary material.
● We also accept manuscripts communicating to a broader audience with regard to research projects financed with public funds.
Scope
● Bionics and biological cybernetics: implantology; bio–abio interfaces
● Bioelectronics: wearable electronics; implantable electronics; “more than Moore” electronics; bioelectronics devices
● Bioprocess and biosystems engineering and applications: bioprocess design; biocatalysis; bioseparation and bioreactors; bioinformatics; bioenergy; etc.
● Biomolecular, cellular and tissue engineering and applications: tissue engineering; chromosome engineering; embryo engineering; cellular, molecular and synthetic biology; metabolic engineering; bio-nanotechnology; micro/nano technologies; genetic engineering; transgenic technology
● Biomedical engineering and applications: biomechatronics; biomedical electronics; biomechanics; biomaterials; biomimetics; biomedical diagnostics; biomedical therapy; biomedical devices; sensors and circuits; biomedical imaging and medical information systems; implants and regenerative medicine; neurotechnology; clinical engineering; rehabilitation engineering
● Biochemical engineering and applications: metabolic pathway engineering; modeling and simulation
● Translational bioengineering