Abstract
Background: We aimed to assess the performance of machine learning algorithms for the prediction of risk factors of postoperative ileus (POI) in patients underwent laparoscopic colorectal surgery for malignant lesions. Methods: We conducted analyses in a retrospective observational study with a total of 637 patients at Suzhou Hospital of Nanjing Medical University. Four machine learning algorithms (logistic regression, decision tree, random forest, gradient boosting decision tree) were considered to predict risk factors of POI. The total cases were randomly divided into training and testing data sets, with a ratio of 8:2. The performance of each model was evaluated by area under receiver operator characteristic curve (AUC), precision, recall and F1-score. Results: The morbidity of POI in this study was 19.15% (122/637). Gradient boosting decision tree reached the highest AUC (0.76) and was the best model for POI risk prediction. In addition, the results of the importance matrix of gradient boosting decision tree showed that the five most important variables were time to first passage of flatus, opioids during POD3, duration of surgery, height and weight. Conclusions: The gradient boosting decision tree was the optimal model to predict the risk of POI in patients underwent laparoscopic colorectal surgery for malignant lesions. And the results of our study could be useful for clinical guidelines in POI risk prediction.
Conversion risk factors in laparoscopic colorectal surgery
