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Predicting short-term thromboembolic risk following Roux-en-Y gastric bypass using supervised machine learning.

Hassam Ali¹, Faisal Inayat², Vishali Moond³

¹Department of Gastroenterology, East Carolina University Brody School of Medicine, Greenville, NC 27834, United States.

World Journal of Gastrointestinal Surgery

|May 1, 2024

Summary

This summary is machine-generated.

A new risk model identifies six key predictors for venous thromboembolism (VTE) after Roux-en-Y gastric bypass (RYGB). This tool aids clinicians in assessing VTE risk for RYGB patients, improving preoperative care.

Keywords:

Bariatric surgery Machine learning Predictive modeling Roux-en-Y gastric bypass Venous thromboembolism

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Published on: August 21, 2021

Area of Science:

Bariatric Surgery
Cardiovascular Health
Medical Informatics

Background:

Roux-en-Y gastric bypass (RYGB) is effective for class III obesity but carries risks.
Venous thromboembolism (VTE) is a significant cause of mortality post-RYGB.
A need exists for a VTE risk assessment tool specific to RYGB patients.

Purpose of the Study:

To develop and validate a scoring system for individualized 30-day VTE risk in RYGB patients.
To identify key predictors of VTE following RYGB surgery.

Main Methods:

Analysis of 6526 RYGB patients from the 2016-2021 MBSAQIP database.
Backward elimination multivariate analysis to identify VTE predictors.
Model validation using 5-fold cross-validation and receiver operating curves.

Main Results:

Six predictors identified: COPD history, length of stay, prior DVT, HbA1c > 7%, venous stasis history, and preoperative anticoagulation.
The risk model demonstrated good discriminatory power with an AUC of 0.79.
The model showed satisfactory performance in sleeve gastrectomy and ESG procedures.

Conclusions:

A simple, six-variable risk model can aid in preoperative VTE risk stratification for RYGB patients.
The model provides insights into factors increasing VTE risk.
This tool supports informed clinical decision-making for bariatric surgery candidates.