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人工智能在下肢骨折并发症早期预测中的应用

Artificial Intelligence Applied in Early Prediction of Lower Limb Fracture Complications.

作者信息

Anghele Aurelian-Dumitrache, Marina Virginia, Dragomir Liliana, Moscu Cosmina Alina, Fulga Iuliu, Anghele Mihaela, Popescu Cristina-Mihaela

机构信息

Doctoral School, "Dunărea de Jos" University, 800201 Galati, Romania.

Medical Department of Occupational Health, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, 800201 Galati, Romania.

出版信息

Clin Pract. 2024 Nov 14;14(6):2507-2521. doi: 10.3390/clinpract14060197.

Abstract

: Artificial intelligence has become a valuable tool for diagnosing and detecting postoperative complications early. Through imaging and biochemical markers, clinicians can anticipate the clinical progression of patients and the risk of long-term complications that could impact the quality of life or even be life-threatening. In this context, artificial intelligence is crucial for identifying early signs of complications and enabling clinicians to take preventive measures before problems worsen. This observational study analyzed medical charts from the electronic archive of the Clinical Emergency Hospital in Galați, Romania, covering a four-year period from 2018 to 2022. A neural network model was developed to analyze various socio-demographic and paraclinical data. Key features included patient demographics, laboratory investigations, and clinical outcomes. Statistical analyses were performed to identify significant risk factors associated with deep venous thrombosis (DVT). The analysis revealed a higher prevalence of female patients (60.78%) compared to male patients, indicating a potential gender-related risk factor for DVT. The incidence of DVT was highest among patients aged 71 to 90 years, affecting 56.86% of individuals in this age group, suggesting that advanced age significantly contributes to the risk of developing DVT. Additionally, among the DVT patients, 15.69% had a body mass index (BMI) greater than 30, categorizing them as obese, which is known to increase the risk of thrombotic events. Furthermore, this study highlighted that the highest frequency of DVT was associated with femur fractures, occurring in 52% of patients with this type of injury. The neural network analysis indicated that elevated levels of direct bilirubin (≥1.5 mg/dL) and prothrombin activity (≤60%) were strong predictors of fracture-related complications, with sensitivity and specificity rates of 78% and 82%, respectively. These findings underscore the importance of monitoring these laboratory markers in at-risk populations for early intervention. This study identified critical risk factors for developing DVT, including advanced age, high BMI, and femur fractures, which necessitate longer recovery periods. Additionally, the findings indicate that elevated direct bilirubin and prothrombin activity play a significant role in predicting DVT development. These results suggest that AI can effectively enhance the anticipation of clinical evolution in patients, aiding in early intervention and management strategies.

摘要

人工智能已成为早期诊断和检测术后并发症的宝贵工具。通过成像和生化标志物,临床医生可以预测患者的临床进展以及可能影响生活质量甚至危及生命的长期并发症风险。在这种情况下,人工智能对于识别并发症的早期迹象并使临床医生能够在问题恶化之前采取预防措施至关重要。这项观察性研究分析了罗马尼亚加拉茨临床急诊医院电子档案中的病历,涵盖了2018年至2022年的四年时间。开发了一个神经网络模型来分析各种社会人口统计学和辅助临床数据。关键特征包括患者人口统计学、实验室检查和临床结果。进行统计分析以确定与深静脉血栓形成(DVT)相关的重要风险因素。分析显示,女性患者的患病率(60.78%)高于男性患者,这表明DVT存在潜在的性别相关风险因素。DVT的发病率在71至90岁的患者中最高,该年龄组中有56.86%的人受影响,这表明高龄是发生DVT风险的重要因素。此外,在DVT患者中,15.69%的人体重指数(BMI)大于30,属于肥胖,已知肥胖会增加血栓形成事件的风险。此外,这项研究强调,DVT的最高发生率与股骨骨折相关,在这类损伤的患者中发生率为52%。神经网络分析表明,直接胆红素水平升高(≥1.5毫克/分升)和凝血酶原活性降低(≤60%)是骨折相关并发症的有力预测指标,敏感性和特异性率分别为78%和82%。这些发现强调了在高危人群中监测这些实验室标志物以进行早期干预的重要性。这项研究确定了发生DVT的关键风险因素,包括高龄、高BMI和股骨骨折,这些因素需要更长的恢复期。此外,研究结果表明,直接胆红素和凝血酶原活性升高在预测DVT发生方面发挥着重要作用。这些结果表明,人工智能可以有效地增强对患者临床进展的预测,有助于早期干预和管理策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c02/11587024/229b2d535886/clinpract-14-00197-g001.jpg

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