Machine learning for prediction of postoperative nausea and vomiting in patients with intravenous patient-controlled analgesia

被引:12
作者
Shim, Jae-Geum [1 ,2 ]
Ryu, Kyoung-Ho [2 ]
Cho, Eun-Ah [2 ]
Ahn, Jin Hee [2 ]
Cha, Yun Byeong [2 ]
Lim, Goeun [2 ]
Lee, Sung Hyun [2 ]
机构
[1] Kyung Hee Univ, Coll Med, Grad Sch, Dept Anesthesiol & Pain Med, Seoul, South Korea
[2] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Anesthesiol & Pain Med, Sch Med, Seoul, South Korea
关键词
MANAGEMENT; SCORE; MODEL; PAIN;
D O I
10.1371/journal.pone.0277957
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Postoperative nausea and vomiting (PONV) is a still highly relevant problem and is known to be a distressing side effect in patients. The aim of this study was to develop a machine learning model to predict PONV up to 24 h with fentanyl-based intravenous patient-controlled analgesia (IV-PCA). Methods From July 2019 and July 2020, data from 2,149 patients who received fentanyl-based IV-PCA for analgesia after non-cardiac surgery under general anesthesia were applied to develop predictive models. The rates of PONV at 1 day after surgery were measured according to patient characteristics as well as anesthetic, surgical, or PCA-related factors. All statistical analyses and computations were performed using the R software. Results A total of 2,149 patients were enrolled in this study, 337 of whom (15.7%) experienced PONV. After applying the machine-learning algorithm and Apfel model to the test dataset to predict PONV, we found that the area under the receiver operating characteristic curve using logistic regression was 0.576 (95% confidence interval [CI], 0.520-0.633), k-nearest neighbor was 0.597 (95% CI, 0.537-0.656), decision tree was 0.561 (95% CI, 0.498-0.625), random forest was 0.610 (95% CI, 0.552-0.668), gradient boosting machine was 0.580 (95% CI, 0.520-0.639), support vector machine was 0.649 (95% CI, 0.592-0.707), artificial neural network was 0.686 (95% CI, 0.630-0.742), and Apfel model was 0.643 (95% CI, 0.596-0.690). Conclusions We developed and validated machine learning models for predicting PONV in the first 24 h. The machine learning model showed better performance than the Apfel model in predicting PONV.
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页数:11
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