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000906978 1001_ $$0P:(DE-HGF)0$$aEickhoff, Roman M.$$b0$$eCorresponding author
000906978 245__ $$aMachine learning prediction model for postoperative outcome after perforated appendicitis
000906978 260__ $$aHeidelberg$$bSpringer$$c2022
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000906978 520__ $$aPurpose Appendectomy for acute appendicitis is one of the most common operative procedures worldwide in both childrenand adults. In particular, complicated (perforated) cases show high variability in individual outcomes. Here, we developedand validated a machine learning prediction model for postoperative outcome of perforated appendicitis.Methods Retrospective analyses of patients with clinically and histologically verified perforated appendicitis over 10 yearswere performed. Demographic and surgical baseline characteristics were used as competing predictors of single-patient out-comes along multiple dimensions via a random forest classifier with stratified subsampling. To assess whether complicationscould be predicted in new, individual cases, the ensuing models were evaluated using a replicated 10-fold cross-validation.Results A total of 163 patients were included in the study. Sixty-four patients underwent laparoscopic surgery, whereasninety-nine patients got a primary open procedure. Interval from admission to appendectomy was 9 ± 12 h and duration ofthe surgery was 74 ± 38 min. Forty-three patients needed intensive care treatment. Overall mortality was 0.6 % and morbid-ity rate was 15%. Severe complications as assessed by Clavien-Dindo > 3 were predictable in new cases with an accuracyof 68%. Need for ICU stay (> 24 h) could be predicted with an accuracy of 88%, whereas prolonged hospitalization (greaterthan 7–15 days) was predicted by the model with an accuracy of 76%.Conclusion We demonstrate that complications following surgery, and in particular, health care system-related outcomeslike intensive care treatment and extended hospitalization, may be well predicted at the individual level from demographicand surgical baseline characteristics through machine learning approaches.
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000906978 7001_ $$0P:(DE-HGF)0$$aBulla, Alwin$$b1
000906978 7001_ $$0P:(DE-Juel1)131678$$aEickhoff, Simon B.$$b2
000906978 7001_ $$0P:(DE-HGF)0$$aHeise, Daniel$$b3
000906978 7001_ $$0P:(DE-HGF)0$$aHelmedag, Marius$$b4
000906978 7001_ $$0P:(DE-HGF)0$$aKroh, Andreas$$b5
000906978 7001_ $$0P:(DE-HGF)0$$aSchmitz, Sophia M.$$b6
000906978 7001_ $$0P:(DE-HGF)0$$aKlink, Christian D.$$b7
000906978 7001_ $$0P:(DE-HGF)0$$aNeumann, Ulf P.$$b8
000906978 7001_ $$0P:(DE-HGF)0$$aLambertz, Andreas$$b9
000906978 773__ $$0PERI:(DE-600)1459390-7$$a10.1007/s00423-022-02456-1$$gVol. 407, no. 2, p. 789 - 795$$n2$$p789 - 795$$tLangenbeck's archives of surgery$$v407$$x0023-8236$$y2022
000906978 8564_ $$uhttps://juser.fz-juelich.de/record/906978/files/Eickhoff2022_Article_MachineLearningPredictionModel.pdf$$yOpenAccess
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