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术中用药数据及预测模型选择对预测术后首次发生心房颤动的意义

Significance of Intraoperative Medication Data and Predictive Model Selection for Predicting Postoperative First-Time Atrial Fibrillation.

作者信息

Yu Jingzhi, Johnson Ethan, Deng Yu, Zhang Shibo, Melnick David S, Etemadi Mozziyar, Kho Abel

机构信息

Center for Health Information Partnerships, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Dept. of Biomedical Engineering, Northwestern University, Chicago, IL, USA.

出版信息

AMIA Jt Summits Transl Sci Proc. 2023 Jun 16;2023:320-329. eCollection 2023.

Abstract

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice and has a well-established association with coronary artery bypass graft (CABG) surgery. Being able to predict post-operative AF (POAF) may improve surgical outcomes. This study retrospectively assembled a large cohort of 3,807 first-time CABG patients with no prior AF to study factors that contribute to occurrence of POAF, in addition to testing models that may predict its incidence. Several clinical features with established relevance to POAF were extracted from the EHR, along with a record of medications administered intra-operatively. Tests of performance with logistic regression, decision tree, and neural network predictive models showed slight improvements when incorporating medication information. Analysis of the clinical and medications data indicate that there may be effects contributing to POAF incidence captured in the medication administration records. Our results show that improved predictive performance is achievable by incorporating a record of medications administered intra-operatively.

摘要

心房颤动(AF)是临床实践中最常见的持续性心律失常,并且与冠状动脉旁路移植术(CABG)手术有着明确的关联。能够预测术后房颤(POAF)可能会改善手术结果。本研究回顾性收集了3807例无既往房颤病史的首次CABG患者的大型队列,以研究导致POAF发生的因素,此外还测试了可能预测其发生率的模型。从电子健康记录(EHR)中提取了与POAF已确定相关的几个临床特征,以及术中给药记录。逻辑回归、决策树和神经网络预测模型的性能测试表明,纳入用药信息后有轻微改善。对临床和用药数据的分析表明,用药记录中可能存在影响POAF发生率的因素。我们的结果表明,通过纳入术中给药记录可以实现更好的预测性能。

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