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56 Using machine learning to predict 30-day readmission and reoperation following resection of supratentorial high-grade gliomas: A national analysis of 9,418 patients.

Published online by Cambridge University Press:  24 April 2023

Abdul Karim Ghaith
Affiliation:
Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA
Marc Ghanem
Affiliation:
Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University
Cameron Zamanian
Affiliation:
Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
Antonio A. Bon Nieves
Affiliation:
Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
Archis Bhandarkar
Affiliation:
Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
Karim Nathani
Affiliation:
Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
Mohamad Bydon
Affiliation:
Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
Alfredo Quiones-Hinojosa
Affiliation:
Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA
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Abstract

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OBJECTIVES/GOALS: High-grade gliomas (HGG) are among the rarest, most aggressive tumors in neurosurgical practice. We aimed to identify the clinical predictors for 30-day readmission and reoperation following HGGs surgery using the NSQIP database and seek to create web-based applications predicting each outcome. METHODS/STUDY POPULATION: We conducted a retrospective, multicenter cohort analysis of patients who underwent resection of supratentorial HGG between January 1, 2016, and December 31, 2020, using the NSQIP database. Demographics and comorbidities were extracted. The primary outcomes were 30-day unplanned readmission and reoperation. A stratified 80:20 split of the available data was carried out. Supervised machine learning algorithms were trained to predict 30-day outcomes. RESULTS/ANTICIPATED RESULTS: A total of 9,418 patients were included in our cohort. The rate of unplanned readmission within 30 days of surgery was 14.9%.Weight, chronic steroid use, pre-operative BUN, and WBC count were associated with a higher risk of readmission. The rate of early unplanned reoperation was 5.47%. Increased weight, higher operative time, and a longer period between hospital admission and the operation were linked to increased risk of early reoperation. Our Random Forest algorithm showed the highest predictive performance for early readmission (AUC = 0.967), while the XG Boost algorithm showed the highest predictive performance for early reoperation (AUC = 0.985).Web-based tools for both outcomes were deployed: https://glioma-readmission.herokuapp.com/, https://glioma-reoperation.herokuapp.com/. DISCUSSION/SIGNIFICANCE: A high fraction of documented early unplanned readmission and reoperation were considered preventable and related to surgery. Machine learning allows better prediction of resected HGG’s prognosis based on findings from baseline methods leading to more personalized patient care.

Type
Biostatistics, Epidemiology, and Research Design
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Author(s), 2023. The Association for Clinical and Translational Science