BACKGROUND Postoperative delirium,particularly prevalent in elderly patients after abdominal cancer surgery,presents significant challenges in clinical management.AIM To develop a synthetic minority oversampling techn...BACKGROUND Postoperative delirium,particularly prevalent in elderly patients after abdominal cancer surgery,presents significant challenges in clinical management.AIM To develop a synthetic minority oversampling technique(SMOTE)-based model for predicting postoperative delirium in elderly abdominal cancer patients.METHODS In this retrospective cohort study,we analyzed data from 611 elderly patients who underwent abdominal malignant tumor surgery at our hospital between September 2020 and October 2022.The incidence of postoperative delirium was recorded for 7 d post-surgery.Patients were divided into delirium and non-delirium groups based on the occurrence of postoperative delirium or not.A multivariate logistic regression model was used to identify risk factors and develop a predictive model for postoperative delirium.The SMOTE technique was applied to enhance the model by oversampling the delirium cases.The model’s predictive accuracy was then validated.RESULTS In our study involving 611 elderly patients with abdominal malignant tumors,multivariate logistic regression analysis identified significant risk factors for postoperative delirium.These included the Charlson comorbidity index,American Society of Anesthesiologists classification,history of cerebrovascular disease,surgical duration,perioperative blood transfusion,and postoperative pain score.The incidence rate of postoperative delirium in our study was 22.91%.The original predictive model(P1)exhibited an area under the receiver operating characteristic curve of 0.862.In comparison,the SMOTE-based logistic early warning model(P2),which utilized the SMOTE oversampling algorithm,showed a slightly lower but comparable area under the curve of 0.856,suggesting no significant difference in performance between the two predictive approaches.CONCLUSION This study confirms that the SMOTE-enhanced predictive model for postoperative delirium in elderly abdominal tumor patients shows performance equivalent to that of traditional methods,effectively addressing data imbalance.展开更多
HIV and AIDS has continued to be a major public health concern, and hence one of the epidemics that the world resolved to end by 2030 as highlighted in sustainable development goals (SDGs). A colossal amount of effort...HIV and AIDS has continued to be a major public health concern, and hence one of the epidemics that the world resolved to end by 2030 as highlighted in sustainable development goals (SDGs). A colossal amount of effort has been taken to reduce new HIV infections, but there are still a significant number of new infections reported. HIV prevalence is more skewed towards the key population who include female sex workers (FSW), men who have sex with men (MSM), and people who inject drugs (PWID). The study design was retrospective and focused on key population enrolled in a comprehensive HIV and AIDS programme by the Kenya Red Cross Society from July 2019 to June 2021. Individuals who were either lost to follow up, defaulted (dropped out, transferred out, or relocated) or died were classified as attrition;while those who were active and alive by the end of the study were classified as retention. The study used density analysis to determine the spatial differences of key population attrition in the 19 targeted counties, and used Kilifi county as an example to map attrition cases in smaller administrative areas (sub-county level). The study used synthetic minority oversampling technique-nominal continuous (SMOTE-NC) to balance the datasets since the cases of attrition were much less than retention. The random survival forests model was then fitted to the balanced dataset. The model correctly identified attrition cases using the predicted ensemble mortality and their survival time using the estimated Kaplan-Meier survival function. The predictive performance of the model was strong and way better than random chance with concordance indices greater than 0.75.展开更多
基金Supported by Discipline Advancement Program of Shanghai Fourth People’s Hospital,No.SY-XKZT-2020-2013.
文摘BACKGROUND Postoperative delirium,particularly prevalent in elderly patients after abdominal cancer surgery,presents significant challenges in clinical management.AIM To develop a synthetic minority oversampling technique(SMOTE)-based model for predicting postoperative delirium in elderly abdominal cancer patients.METHODS In this retrospective cohort study,we analyzed data from 611 elderly patients who underwent abdominal malignant tumor surgery at our hospital between September 2020 and October 2022.The incidence of postoperative delirium was recorded for 7 d post-surgery.Patients were divided into delirium and non-delirium groups based on the occurrence of postoperative delirium or not.A multivariate logistic regression model was used to identify risk factors and develop a predictive model for postoperative delirium.The SMOTE technique was applied to enhance the model by oversampling the delirium cases.The model’s predictive accuracy was then validated.RESULTS In our study involving 611 elderly patients with abdominal malignant tumors,multivariate logistic regression analysis identified significant risk factors for postoperative delirium.These included the Charlson comorbidity index,American Society of Anesthesiologists classification,history of cerebrovascular disease,surgical duration,perioperative blood transfusion,and postoperative pain score.The incidence rate of postoperative delirium in our study was 22.91%.The original predictive model(P1)exhibited an area under the receiver operating characteristic curve of 0.862.In comparison,the SMOTE-based logistic early warning model(P2),which utilized the SMOTE oversampling algorithm,showed a slightly lower but comparable area under the curve of 0.856,suggesting no significant difference in performance between the two predictive approaches.CONCLUSION This study confirms that the SMOTE-enhanced predictive model for postoperative delirium in elderly abdominal tumor patients shows performance equivalent to that of traditional methods,effectively addressing data imbalance.
文摘HIV and AIDS has continued to be a major public health concern, and hence one of the epidemics that the world resolved to end by 2030 as highlighted in sustainable development goals (SDGs). A colossal amount of effort has been taken to reduce new HIV infections, but there are still a significant number of new infections reported. HIV prevalence is more skewed towards the key population who include female sex workers (FSW), men who have sex with men (MSM), and people who inject drugs (PWID). The study design was retrospective and focused on key population enrolled in a comprehensive HIV and AIDS programme by the Kenya Red Cross Society from July 2019 to June 2021. Individuals who were either lost to follow up, defaulted (dropped out, transferred out, or relocated) or died were classified as attrition;while those who were active and alive by the end of the study were classified as retention. The study used density analysis to determine the spatial differences of key population attrition in the 19 targeted counties, and used Kilifi county as an example to map attrition cases in smaller administrative areas (sub-county level). The study used synthetic minority oversampling technique-nominal continuous (SMOTE-NC) to balance the datasets since the cases of attrition were much less than retention. The random survival forests model was then fitted to the balanced dataset. The model correctly identified attrition cases using the predicted ensemble mortality and their survival time using the estimated Kaplan-Meier survival function. The predictive performance of the model was strong and way better than random chance with concordance indices greater than 0.75.
