通过机器学习方法检测的严重出血的风险因素,在接受肝切除的患者中,控制的中央静脉低压技术进行了切除
Jing Liu1, Bingbing Cao2, Yuelian Luo2
1Department of Anesthesiology, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China.
Postgraduate medical journal
|October 5, 2023
概括
机器学习模型可以使用控制的中央静脉低压 (CLCVP) 技术预测肝切除期间的严重出血. 增加的普林格尔机动持续时间和乳酸水平是XGBoost模型识别的关键风险因素.
科学领域:
- 麻醉学和外科瘤学
- 机器学习在医学中的应用
- 肝胆道手术 肝胆道手术
背景情况:
- 控制的低中心静脉压 (CLCVP) 已被证实可以减少肝切除过程中的出血.
- 现有的评分方法没有预测CLCVP在肝脏手术期间的出血风险.
研究的目的:
- 开发一种机器学习模型,用于预测CLCVP肝切除术患者的重大出血风险.
- 鉴定导致手术内出血的关键风险因素,尽管CLCVP.
主要方法:
- 对1077名肝切除患者的回顾性审查 (2017年1月 - 2020年6月).
- 使用5倍交叉验证的XGBoost和后勤回归模型的比较.
- 使用夏普利添加式解释 (SHAP) 进行因子重要性分析.
主要成果:
- XGBoost分类器实现了比物流回归 (精度0.76,精度0.79) 更高的性能 (精度0.80,精度0.89).
- 主要出血的主要预测因素包括手术内血红素,手术持续时间,手术内乳酸,手术前血红素,手术前酸氨酸酶和普林格尔机动持续时间.
结论:
- XGBoost模型有效地预测了CLCVP.肝切除术中的重大出血风险.
- 麻醉师应监测普林格尔手动的持续时间和乳酸盐水平作为危急出血风险因素.
相关概念视频
Esophageal Varices-II: Clinical Features and Management
76
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
76
Venous Thrombosis IV: Nursing Management
14
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
14
Pre-Procedural Guidelines for Assessing Blood Pressure
578
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
578


