[Prediction of hemorrhage rate after tonsil surgery in children based on random forest model]

Objective:Hemorrhage after tonsil surgery in children is a serious and potentially life-threatening complication. The purpose of this study was to establish a risk warning model for hemorrhage after tonsil surgery in children through a national multi-center retrospective study, providing a basis for hierarchical management after tonsil surgery in children. Methods:Stratified sampling was performed on 8 854 children who underwent tonsillectomy under general anesthesia from 15 research centers in different provinces from January 15, 2022 to May 15, 2023. The sample size of this study was 2 724 cases, including 1 096 males and 1 628 females. Children were divided into bleeding and non-bleeding groups according to whether or not they had bleeding after surgery. The random forest algorithm was used to build a risk warning model. By continuously exploring the optimized model, the accuracy of predicting the postoperative bleeding rate of tonsils in children was improved, and the prediction effectiveness of the model was verified by ten-fold cross-validation. Results:Among 2 724 children, 117 had postoperative bleeding after tonsillectomy, with a bleeding rate of 4.30%. The model constructed by the random forest algorithm for the training set was verified in the test set, and the obtained prediction accuracy was 98.72%, the recall rate was 78.95%, and the area under the ROC curve AUC was 0.96. Conclusion:Although the recall rate of the random forest model needs to be improved, the overall accuracy is quite excellent. It can effectively avoid misjudging positive cases as negative cases. It is a useful tool that can be used to predict the postoperative bleeding rate of tonsils and clinical medical decision-making, laying a good foundation for subsequent optimization and improvement.