Zhu Kun, Zhang Zi-Xuan, Zhang Miao
The Second Department of Anesthesia, Tianjin Hospital, Tianjin 300211, China.
Department of War Rescue Training, Qingdao Special Servicemen Recuperation Center of PLA Navy, Qingdao 266001, Shandong Province, China.
World J Clin Cases. 2024 Aug 26;12(24):5513-5522. doi: 10.12998/wjcc.v12.i24.5513.
Hypothermia during laparoscopic surgery in patients with multiple trauma is a significant concern owing to its potential complications. Machine learning models offer a promising approach to predict the occurrence of intraoperative hypothermia.
To investigate the value of machine learning model to predict hypothermia during laparoscopic surgery in patients with multiple trauma.
This retrospective study enrolled 220 patients who were admitted with multiple injuries between June 2018 and December 2023. Of these, 154 patients were allocated to a training set and the remaining 66 were allocated to a validation set in a 7:3 ratio. In the training set, 53 cases experienced intraoperative hypothermia and 101 did not. Logistic regression analysis was used to construct a predictive model of intraoperative hypothermia in patients with polytrauma undergoing laparoscopic surgery. The area under the curve (AUC), sensitivity, and specificity were calculated.
Comparison of the hypothermia and non-hypothermia groups found significant differences in sex, age, baseline temperature, intraoperative temperature, duration of anesthesia, duration of surgery, intraoperative fluid infusion, crystalloid infusion, colloid infusion, and pneumoperitoneum volume ( < 0.05). Differences between other characteristics were not significant ( > 0.05). The results of the logistic regression analysis showed that age, baseline temperature, intraoperative temperature, duration of anesthesia, and duration of surgery were independent influencing factors for intraoperative hypothermia during laparoscopic surgery ( < 0.05). Calibration curve analysis showed good consistency between the predicted occurrence of intraoperative hypothermia and the actual occurrence ( > 0.05). The predictive model had AUCs of 0.850 and 0.829 for the training and validation sets, respectively.
Machine learning effectively predicted intraoperative hypothermia in polytrauma patients undergoing laparoscopic surgery, which improved surgical safety and patient recovery.
由于存在潜在并发症,多发伤患者在腹腔镜手术期间出现体温过低是一个重大问题。机器学习模型为预测术中体温过低的发生提供了一种有前景的方法。
探讨机器学习模型对预测多发伤患者腹腔镜手术期间体温过低的价值。
这项回顾性研究纳入了2018年6月至2023年12月期间因多发伤入院的220例患者。其中,154例患者被分配到训练集,其余66例以7:3的比例分配到验证集。在训练集中,53例患者术中出现体温过低,101例未出现。采用逻辑回归分析构建多发伤患者腹腔镜手术术中体温过低的预测模型。计算曲线下面积(AUC)、敏感性和特异性。
体温过低组与非体温过低组比较,在性别、年龄、基础体温、术中体温、麻醉持续时间、手术持续时间、术中液体输注量、晶体液输注量、胶体液输注量和气腹体积方面存在显著差异(<0.05)。其他特征之间的差异不显著(>0.05)。逻辑回归分析结果显示,年龄、基础体温、术中体温、麻醉持续时间和手术持续时间是腹腔镜手术术中体温过低的独立影响因素(<0.05)。校准曲线分析显示,术中体温过低的预测发生率与实际发生率之间具有良好的一致性(>0.05)。该预测模型在训练集和验证集的AUC分别为0.850和0.829。
机器学习有效地预测了多发伤患者腹腔镜手术术中体温过低的情况,提高了手术安全性和患者恢复情况。