Predicting Prolonged Length of Hospital Stay and Identifying Risk Factors Following Total Ankle Arthroplasty: A Supervised Machine Learning Methodology.

Ankle osteoarthritis (OA) is a debilitating condition that arises as a result of trauma or injury to the ankle and often progresses to chronic pain and loss of function that may require surgical intervention. Total ankle arthroplasty (TAA) has emerged as a means of operative treatment for end-stage...

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Published in:Journal of Foot & Ankle Surgery Vol. 63; no. 5; pp. 557 - 562
Main Authors: Chirongoma, Tadiwanashe, Cabrera, Andrew, Bouterse, Alexander, Chung, David, Patton, Daniel, Essilfie, Anthony
Format: research Journal Article
Published: W B Saunders Sep2024
Online Access:View this record in EBSCOhost
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      issn: 10672516
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      dt: Sep2024
      vid: 63
      iid: 5
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      pub: W B Saunders
      place: Philadelphia, Pennsylvania
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        10.1053/j.jfas.2024.05.005
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        atl: Predicting Prolonged Length of Hospital Stay and Identifying Risk Factors Following Total Ankle Arthroplasty: A Supervised Machine Learning Methodology.
      aug:
        au:
          Chirongoma, Tadiwanashe
          Cabrera, Andrew
          Bouterse, Alexander
          Chung, David
          Patton, Daniel
          Essilfie, Anthony
        affil: School of Medicine, Loma Linda University, Loma Linda, CA
      sug:
        subj:
          Arthroplasty, Replacement, Ankle Adverse Effects
          Postoperative Complications Risk Factors
          Length of Stay
          Risk Assessment
          Machine Learning
          Algorithms
          Human
          Osteoarthritis, Ankle Surgery
          Surgery, Elective
          Male
          Female
          Sex Factors
          Postoperative Period
          Sodium Blood
          Preoperative Period
          Hematocrit
          Diabetes Mellitus
          Creatinine Blood
          Body Mass Index
          Leukocyte Count
          Hispanic Americans
          Race Factors
          Descriptive Statistics
          Sensitivity and Specificity
          Decision Making, Clinical
          Male
          Female
      ab: Ankle osteoarthritis (OA) is a debilitating condition that arises as a result of trauma or injury to the ankle and often progresses to chronic pain and loss of function that may require surgical intervention. Total ankle arthroplasty (TAA) has emerged as a means of operative treatment for end-stage ankle OA. Increased hospital length of stay (LOS) is a common adverse postoperative outcome that increases both the complications and cost of care associated with arthroplasty procedures. The purpose of this study was to employ four machine learning (ML) algorithms to predict LOS in patients undergoing TAA using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. The ACS-NSQIP database was queried to identify adult patients undergoing elective TAA from 2008 to 2018. Four supervised ML classification algorithms were utilized and tasked with predicting increased hospital length of stay (LOS). Among these variables, female sex, ASA Class III, preoperative sodium, preoperative hematocrit, diabetes, preoperative creatinine, other arthritis, BMI, preoperative WBC, and Hispanic ethnicity carried the highest importance across predictions generated by 4 independent ML algorithms. Predictions generated by these algorithms were made with an average AUC of 0.7257, as well as an average accuracy of 73.98% and an average sensitivity and specificity of 48.47% and 79.38%, respectively. These findings may be useful for guiding decision-making within the perioperative period and may serve to identify patients at increased risk for a prolonged LOS.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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