Validation of the Artificial Intelligence-Based Predictive Optimal Trees in Emergency Surgery Risk (POTTER) Calculator in Emergency General Surgery and Emergency Laparotomy Patients - 21/05/21
Abstract |
Background |
The Predictive Optimal Trees in Emergency Surgery Risk (POTTER) tool is an artificial intelligence-based calculator for the prediction of 30-day outcomes in patients undergoing emergency operations. In this study, we sought to assess the performance of POTTER in the emergency general surgery (EGS) population in particular.
Methods |
All patients who underwent EGS in the 2017 American College of Surgeons NSQIP database were included. The performance of POTTER in predicting 30-day postoperative mortality, morbidity, and 18 specific complications was assessed using the c-statistic metric. As a subgroup analysis, the performance of POTTER in predicting the outcomes of patients undergoing emergency laparotomy was assessed.
Results |
A total of 59,955 patients were included. Median age was 50 years and 51.3% were women. POTTER predicted mortality (c-statistic = 0.93) and morbidity (c-statistic = 0.83) extremely well. Among individual complications, POTTER had the highest performance in predicting septic shock (c-statistic = 0.93), respiratory failure requiring mechanical ventilation for 48 hours or longer (c-statistic = 0.92), and acute renal failure (c-statistic = 0.92). Among patients undergoing emergency laparotomy, the c-statistic performances of POTTER in predicting mortality and morbidity were 0.86 and 0.77, respectively.
Conclusions |
POTTER is an interpretable, accurate, and user-friendly predictor of 30-day outcomes in patients undergoing EGS. POTTER could prove useful for bedside counseling of patients and their families and for benchmarking of EGS care.
Le texte complet de cet article est disponible en PDF.Visual Abstract |
Abbreviations and Acronyms : ACS, CKD, EGS, EL, EMR, HF, ML, OCT, POTTER
Plan
| Disclosure Information: Nothing to disclose. |
|
| Disclosures outside the scope of this work: Dr Bertsimas serves on the boards of Benefit Science Technologies, Interpretable AI, ReClaim, Savvi Financial, and Dynamic Ideas Publishing. Mr Levine and Drs Zhou, Dunn, and Bertsimas hold equity in Alexandria Health. Mr Levine co-founded Alexandria Health. |
Vol 232 - N° 6
P. 912 - juin 2021 Retour au numéro
Article précédent
- National Population Study of the Effect of Structure and Process on Outcomes of Digit Replantation
- Chung-Chen Hsu, Sunitha Malay, Jung-Sheng Chen, Charles Yuen Yung Loh, Yu-Te Lin, Kevin C. Chung
- Care Fragmentation and Mortality in Readmission after Surgery for Hepatopancreatobiliary and Gastric Cancer: A Patient-Level and Hospital-Level Analysis of the Healthcare Cost and Utilization Project Administrative Database
- David G. Brauer, Ningying Wu, Matthew R. Keller, Sarah A. Humble, Ryan C. Fields, Chet W. Hammill, William G. Hawkins, Graham A. Colditz, Dominic E. Sanford
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?