Jin Xue

and 5 more

Objective This retrospective cohort study aimed to identify reasons and risk factors associated with 30-day readmission after otolaryngology-head and neck surgery and propose preventive measures. Design The study was conducted at a large single academic tertiary care center in China, analyzing cases of inpatient otolaryngology-head and neck surgery from August 2019 to December 2021. Setting The study was conducted in a large tertiary-care hospital in China. Participants The study included adult patients who underwent otolaryngology-head and neck surgery and experienced 30-day readmissions. Main outcome measures The main outcome measured was the analysis of 30-day readmissions for adult patients after otolaryngology-head and neck surgery. Results A total of 7,608 otolaryngology-head and neck surgery patients were identified, with 0.85% and 0.84% experiencing unplanned and planned readmissions within 30 days, respectively. Patients with unplanned readmissions were older and had a longer length of stay compared to those with planned readmissions and those without readmissions. Old age and length of stay were identified as risk factors for unplanned readmission. The most common reasons for unplanned and planned readmissions were surgical complications and surgical cancellations, respectively. Conclusions Analyzing the causes and risk factors for 30-day readmissions after otolaryngology-head and neck surgery can guide perioperative planning and help prevent readmissions, leading to improved patient outcomes.

dongfeng liu

and 4 more

Rationale, aims and objectives: Intracerebral hemorrhage (ICH), the second most common cause of stroke, has a high fatality rate. The establishment of mortality prediction models based on ICH patients and disease characteristics is very useful for clinical decision-making and corresponding treatment methods. Therefore, we used five machine learning methods to establish models for predicting in-hospital mortality in ICH patients and compared models’ performance. Methods: Model development and performance comparisons were performed using the medical information mart for intensive care (MIMIC-III) database. We took the maximum and minimum values of each index of 1143 ICH patients in the first, second and third days after admission as the input variables of the model, and established five machine learning models including random forest (RF), Gradient Boosting Decision Tree (GBDT), decision tree, Naïve Bayes and KNN. The most important feature variables were selected by the RF model and Least Absolute Shrinkage and Selection Operator (LASSO) method. The area under the receiver operating characteristic curve (AUROC), accuracy, precision, recall, and F1 score were used as the assessment criteria of the model prediction effect. Results: After 5-fold cross-validation, the AUROC of RF, GBDT, Naïve Bayes, Decision Tree and KNN models were 0.92, 0.93, 0.9, 0.89, 0.89, respectively. The performance of GBDT was better than other prediction models. The accuracy, precision, recall, and F1 score of the GBDT model were respectively 0.87, 0.84, 0.76, and 0.79. Conclusions: There is great potential for machine learning in mortality prediction for ICH patients in ICU. Considering the above five models, we believe that GBDT is an appropriate tool for clinicians to predict ICH patient mortality.