Data analytics and artificial intelligence to predict length of stay, readmission and mortality after colorectal cancer surgery

2021 ◽  
Vol 47 (2) ◽  
pp. e5
Author(s):  
Shamsul Masum ◽  
Adrian Hopgood ◽  
Samuel Stefan ◽  
Karen Flashman ◽  
Jim S. Khan
2021 ◽  
Author(s):  
Shamsul Masum ◽  
Adrian Hopgood ◽  
Samuel Stefan ◽  
Karen Flashman ◽  
Jim Khan

Abstract Data analytics and artificial intelligence (AI) have been used to predict patient outcomes after colorectal cancer surgery. A prospectively maintained colorectal cancer database was used, covering 4336 patients who underwent colorectal cancer surgery between 2003 and 2019. The 47 patient parameters included demographics, peri- and post-operative outcomes, surgical approaches, complications, and mortality. Data analytics were used to compare the importance of each variable and AI prediction models were built for length of stay (LOS), readmission, and mortality. Accuracies of at least 80% have been achieved. The significant predictors of LOS were age, ASA grade, operative time, presence or absence of a stoma, robotic or laparoscopic approach to surgery, and complications. The model with support vector regressor (SVR) algorithms predicted the LOS with an accuracy of 83% and mean absolute error (MAE) of 9.69 days. The significant predictors of readmission were age, laparoscopic procedure, stoma performed, preoperative nodal (N) stage, operation time, operation mode, previous surgery type, LOS, and the specific procedure. A BI-LSTM model predicted readmission with 87.5% accuracy, 84% sensitivity, and 90% specificity. The significant predictors of mortality were age, ASA grade, BMI, the formation of a stoma, preoperative TNM staging, neoadjuvant chemotherapy, curative resection, and LOS. Classification predictive modelling predicted three different colorectal cancer mortality measures (overall mortality, and 31- and 91-days mortality) with 80-96% accuracy, 84-93% sensitivity, and 75-100% specificity. A model using all variables performed only slightly better than one that used just the most significant ones.


2016 ◽  
Vol 4 ◽  
pp. 205031211666700 ◽  
Author(s):  
Morten Westergaard Noack ◽  
Anne Sofie Bisgård ◽  
Mads Klein ◽  
Jacob Rosenberg ◽  
Ismail Gögenur

Background/Aims: Hypnotics are used to treat perioperative sleep disorders. These drugs are associated with a higher risk of adverse effects among patients undergoing surgery. This study aims to quantify the use of hypnotics and factors influencing the administration of hypnotics in relation to colorectal cancer surgery. Method: A retrospective cohort study of 1979 patients undergoing colorectal cancer surgery. Results: In all, 381 patients (19%) received new treatment with hypnotics. Two of the six surgical centres used hypnotics less often (odds ratio (95% confidence interval), 0.24 (0.16–0.38) and 0.20 (0.12–0.35)). Active smokers (odds ratio (95% confidence interval), 1.57 (1.11–2.24)) and patients receiving perioperative blood transfusion (odds ratio (95% confidence interval), 1.58 (1.10–2.26)) had increased likelihood of receiving hypnotics. In the uncomplicated cases, a multivariable linear regression analysis showed that consumption of hypnotics postoperatively was significantly associated with increased length of stay (1.5 (0.9–2.2) days). Conclusion: One in five patients began treatment with hypnotics after colorectal cancer surgery. Postoperative use of hypnotics was associated with an increased length of stay for uncomplicated cases of colorectal cancer surgery.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Hanna ◽  
C Khoory ◽  
N Manu ◽  
R Clifford ◽  
H Fowler ◽  
...  

Abstract Aim Post-operative pulmonary complications in perioperative SARS-CoV-2 infection are associated with significant morbidity and mortality. To maintain a safe cancer service, the Countess of Chester Hospital adopted “Cold-site” operating and maintained ERAS principles for patients undergoing elective colorectal cancer surgery during the pandemic. A comparative assessment of service was undertaken for benchmarking purposes. Method A comparative retrospective audit was undertaken of consecutive patients undergoing elective colorectal cancer surgery from June to November 2019 and compared to June to November 2020. The Somerset Cancer Registry and electronic medical case records were used to obtain the dataset. Outcomes measured were approach to surgery; stoma rate; length of stay; level of care required; post-operative complications (>Clavien-Dindo 2) and survival at 30 days. Mann-Whitney U test and Chi-squared were used for analysis. Results There were 33 and 24 elective colorectal cancer operations in 2019 and 2020 respectively. There was no difference in the median age (64:69; p = 0.3) or ASA grade (p = 0.9). The median length of stay was 5 and 4 days respectively (p = 0.3). There was a 32.2% reduction in laparoscopic approach to surgery in 2020 (69.7% vs 37.5%; p = 0.02). There was no difference in the stoma rate (p = 0.9), post-operative complication rate (p = 0.7), ITU admission rate (p = 0.3), length of ITU stay (p = 0.6) and 30-day mortality rates (p = 0.4). Conclusions “Cold-site” operating allows robust ERAS care to be adopted to ensure comparative outcomes for patients undergoing colorectal cancer surgery and was associated with a non-significant trend to shorter hospital stay during the COVID-19 pandemic.


2019 ◽  
Vol 44 (1) ◽  
pp. 73-82
Author(s):  
Don Vicendese ◽  
Luc Te Marvelde ◽  
Peter D. McNair ◽  
Kathryn Whitfield ◽  
Dallas R. English ◽  
...  

Medicine ◽  
2016 ◽  
Vol 95 (47) ◽  
pp. e5064 ◽  
Author(s):  
Ariadni Aravani ◽  
Elizabeth F. Samy ◽  
James D. Thomas ◽  
Phil Quirke ◽  
Eva J.A. Morris ◽  
...  

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