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논문 기본 정보

자료유형
학술저널
저자정보
Karabacak Mert (Department of Neurosurgery, Mount Sinai Health System, New York, NY, USA) Schupper Alexander (Department of Neurosurgery, Mount Sinai Health System, New York, NY, USA) Carr Matthew (Department of Neurosurgery, Mount Sinai Health System, New York, NY, USA) Margetis Konstantinos (Department of Neurosurgery, Mount Sinai Health System, New York, NY, USA)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.18 No.4
발행연도
2024.8
수록면
541 - 549 (9page)
DOI
10.31616/asj.2024.0048

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Study Design: A retrospective machine learning (ML) classification study for prognostic modeling after anterior cervical corpectomy (ACC).Purpose: To evaluate the effectiveness of ML in predicting ACC outcomes and develop an accessible, user-friendly tool for this purpose.Overview of Literature: Based on our literature review, no study has examined the capability of ML algorithms to predict major shortterm ACC outcomes, such as prolonged length of hospital stay (LOS), non-home discharge, and major complications.Methods: The American College of Surgeons’ National Surgical Quality Improvement Program database was used to identify patients who underwent ACC. Prolonged LOS, non-home discharges, and major complications were assessed as the outcomes of interest. ML models were developed with the TabPFN algorithm and integrated into an open-access website to predict these outcomes.Results: The models for predicting prolonged LOS, non-home discharges, and major complications demonstrated mean areas under the receiver operating characteristic curve (AUROC) of 0.802, 0.816, and 0.702, respectively. These findings highlight the discriminatory capacities of the models: fair (AUROC >0.7) for differentiating patients with major complications from those without, and good (AUROC >0.8) for distinguishing between those with and without prolonged LOS and non-home discharges. According to the SHapley Additive Explanations analysis, single- versus multiple-level surgery, age, body mass index, preoperative hematocrit, and American Society of Anesthesiologists physical status repetitively emerged as the most important variables for each outcome.Conclusions: This study has considerably enhanced the prediction of postoperative results after ACC surgery by implementing advanced ML techniques. A major contribution is the creation of an accessible web application, highlighting the practical value of the developed models. Our findings imply that ML can serve as an invaluable supplementary tool to stratify patient risk for this procedure and can predict diverse postoperative adverse outcomes.

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