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  • 1
    Online Resource
    Online Resource
    Prediction of postoperative infection in elderly using deep learning-based analysis: an observational cohort study
    Springer Science and Business Media LLC ; 2023
    In:  Aging Clinical and Experimental Research Vol. 35, No. 3 ( 2023-01-04), p. 639-647
    Details
    In: Aging Clinical and Experimental Research, Springer Science and Business Media LLC, Vol. 35, No. 3 ( 2023-01-04), p. 639-647
    Abstract: Elderly patients are susceptible to postoperative infections with increased mortality. Analyzing with a deep learning model, the perioperative factors that could predict and/or contribute to postoperative infections may improve the outcome in elderly. This was an observational cohort study with 2014 elderly patients who had elective surgery from 28 hospitals in China from April to June 2014. We aimed to develop and validate deep learning-based predictive models for postoperative infections in the elderly. 1510 patients were randomly assigned to be training dataset for establishing deep learning-based models, and 504 patients were used to validate the effectiveness of these models. The conventional model predicted postoperative infections was 0.728 (95% CI 0.688–0.768) with the sensitivity of 66.2% (95% CI 58.2–73.6) and specificity of 66.8% (95% CI 64.6–68.9). The deep learning model including risk factors relevant to baseline clinical characteristics predicted postoperative infections was 0.641 (95% CI 0.545–0.737), and sensitivity and specificity were 34.2% (95% CI 19.6–51.4) and 88.8% (95% CI 85.6–91.6), respectively. Including risk factors relevant to baseline variables and surgery, the deep learning model predicted postoperative infections was 0.763 (95% CI 0.681–0.844) with the sensitivity of 63.2% (95% CI 46–78.2) and specificity of 80.5% (95% CI 76.6–84). Our feasibility study indicated that a deep learning model including risk factors for the prediction of postoperative infections can be achieved in elderly. Further study is needed to assess whether this model can be used to guide clinical practice to improve surgical outcomes in elderly.
    Type of Medium: Online Resource
    ISSN: 1720-8319
    URL: Article
    DOI: 10.1007/s40520-022-02325-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2119282-0
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  • 2
    Online Resource
    Online Resource
    Postoperative infectious complications in elderly patients after elective surgery in China: results of a 7‐day cohort study from the International Surgical Outcomes Study
    Wiley ; 2021
    In:  Psychogeriatrics Vol. 21, No. 2 ( 2021-03), p. 158-165
    Details
    In: Psychogeriatrics, Wiley, Vol. 21, No. 2 ( 2021-03), p. 158-165
    Abstract: Despite initiatives to increase elderly patients’ access to surgical treatments, the prevalence and impact of postoperative infectious complications (PICs) in elderly patients in China are poorly described. The aim of our study was to describe PICs and associated mortality in elderly patients undertaking elective surgery in China. Methods We analyzed data about elderly patients from China during the International Surgical Outcomes Study (ISOS), a 7‐day prospective cohort study of outcomes after elective surgery in in‐patient adults. All elderly patients (age ≥60 years) from 28 hospitals in China included in the ISOS study were included in this study as well. A review of 2014 elderly patients who underwent elective surgery in April 2014 was conducted. Results Of 2014 elderly patients, 209 (10.4%) developed at least one postoperative complication. Infectious complications were most frequent, affecting 154 patients (7.6%); there was one death, or 0.6% 30‐day mortality, which was a significantly higher rate than among patients without PICs (0%). The most frequent infectious complication was superficial surgical‐site infection (3.3%). The length of hospital stay was longer in elderly patients with PICs than in those without PICs. Moreover, a total of 142 elderly patients (7.1%) were routinely sent to critical care after surgery, of whom 97 (68.3%) developed PICs. Compared to elderly patients admitted to a standard ward, those admitted to critical care immediately after surgery had a higher postoperative complication rate and critical care admission rate to treat complications. Conclusions The present prospective, multicentre study found that 7.6% of elderly patients in China had PICs after elective surgery that could prolong hospital stay and increase 30‐day mortality. The clinical effectiveness of admission to critical care after surgery on elderly patients is not identified. Initiatives to increase elderly patients’ access to surgical interventions should also enhance safe perioperative care to reduce PICs in China.
    Type of Medium: Online Resource
    ISSN: 1346-3500 , 1479-8301
    URL: Issue
    URL: Article
    DOI: 10.1111/psyg.v21.2
    DOI: 10.1111/psyg.12648
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2110287-9
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