Department of Mechanical Engineering, Faculty of Engineering, 532719Istanbul University-Cerrahpaşa, Avcilar-Istanbul, Turkey.
Department of Anesthesiology and Reanimation, Medical School of Cerrahpaşa, 532719Istanbul University-Cerrahpasa, Fatih-Istanbul, Turkey.
Am Surg. 2023 Mar;89(3):414-423. doi: 10.1177/00031348211029872. Epub 2021 Jun 29.
Pre-operative risk classification of patients undergoing anesthesia is an essential interest and has been the focus of many research and categorizations. On the other hand, the ideal categorization system, based on medical doctors' clinical experience and cooperation with other disciplines, has not been developed yet.
In this study, 218 consecutive patient undergoing laparoscopic cholecystectomy operations were included. A novel fuzzy logic evaluation model consisting of 270 rules was constructed. Five major (pulmonary, cardiac, diabetes mellitus and renal or liver disease) and three minor criteria (patients' age, cigarette smoking and body mass index) were chosen to be used during high-risk groups determination.
The verification of the success of risk value decision with the proposed novel fuzzy logic algorithm is the main goal of this study. On the other hand, though not essential aim, a statistical consistency check was also included to have a deeper understanding and evaluation of the graphical results. During the statistical analysis the 0-30%, 30-60% and 60-90% risk ranges were found to be in a very strong positive relationship with complication occurrence. In this study, 172, 31, 15 patients were in 0-30, 30-60 and 60-90% risk ranges, respectively. Complication rates were 7/172 (4.07%) in 0-30% range, 3/31 (9.68%) in 30-60% range; and 2/15 (13.33%) in 60-90% range.
Fuzzy based risk classification model was successfully used to predict medical results for patients undergoing laparoscopic cholecystectomy operations and reliable deductions were reached.
对接受麻醉的患者进行术前风险分类是一项重要的工作,也是许多研究和分类的重点。另一方面,基于医生临床经验并与其他学科合作的理想分类系统尚未开发出来。
本研究纳入了 218 例接受腹腔镜胆囊切除术的连续患者。构建了一个由 270 条规则组成的新的模糊逻辑评估模型。选择五个主要标准(肺部、心脏、糖尿病和肾或肝疾病)和三个次要标准(患者年龄、吸烟和体重指数)来确定高危组。
本研究的主要目标是验证提出的新型模糊逻辑算法对风险值决策的成功验证。另一方面,虽然不是必要的目标,但也包括了统计一致性检查,以更深入地了解和评估图形结果。在统计分析中,发现 0-30%、30-60%和 60-90%的风险范围与并发症发生呈很强的正相关关系。在本研究中,172、31、15 例患者分别处于 0-30%、30-60%和 60-90%的风险范围内。0-30%风险范围内的并发症发生率为 7/172(4.07%),30-60%风险范围内为 3/31(9.68%),60-90%风险范围内为 2/15(13.33%)。
模糊风险分类模型成功地用于预测接受腹腔镜胆囊切除术的患者的医疗结果,并得出了可靠的推论。