Backgrounds: New methods such as machine learning could provide accurate predictions with little statistical assumptions. We seek to develop prediction model of pediatric surgical complications based on pediatric National Surgical Quality Improvement Program(NSQIP).
Methods: All 2012-2018 pediatric-NSQIP procedures were reviewed. Primary outcome was defined as 30-day post-operative morbidity/mortality. Morbidity was further classified as any, major and minor. Models were developed using 2012-2017 data. 2018 data was used as independent performance evaluation.
Results: 431,148 patients were included in the 2012-2017 training and 108,604 were included in the 2018 testing set. Our prediction models had high performance in mortality prediction at 0.94 AUC in testing set. Our models outperformed ACS-NSQIP Calculator in all categories for morbidity (0.90 AUC for major, 0.86 AUC for any, 0.69 AUC in minor complications).
Conclusions: We developed a high-performing pediatric surgical risk prediction model. This powerful tool could potentially be used to improve the surgical care quality.
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http://dx.doi.org/10.1016/j.amjsurg.2023.03.009 | DOI Listing |
Cancer Med
January 2025
Department of Pediatric Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Background: Medical images play an important role in diagnosis and treatment of pediatric solid tumors. The field of radiology, pathology, and other image-based diagnostics are getting increasingly important and advanced. This indicates a need for advanced image processing technology such as Deep Learning (DL).
View Article and Find Full Text PDFAnesth Crit Care
October 2024
Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona CA 91766, USA.
Healthcare disparities continue to affect communities in the United States that are racially and ethnically diverse, disabled, and economically disadvantaged, even though medical and technological advancements have made great strides in these areas. Disparities in health outcomes and difficulties obtaining care for both acute and chronic illnesses are more common among these populations when compared to the overall population. Disparities in anesthesia care delivery have been documented in multiple studies, and they are based on factors such as patients' racial/ethnic background, gender, sexual orientation, ability to communicate in English, and accessibility to health insurance.
View Article and Find Full Text PDFWorld J Gastroenterol
January 2025
Senior Department of Hematology, The Fifth Medical Center of PLA General Hospital, Beijing 100071, China.
In this article, we comment on an article published in a recent issue of the . We specifically focus on the roles of human leukocyte antigen (HLA) and donor-specific antibodies (DSAs) in pediatric liver transplantation (LT), as well as the relationship between immune rejection after LT and DSA. Currently, LT remains the standard of care for pediatric patients with end-stage liver disease or severe acute liver failure.
View Article and Find Full Text PDFIowa Orthop J
January 2025
Department of Orthopaedic Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA.
Background: This study aims to determine the rate of surgical intervention in children with type IIA supracondylar humerus fractures (SCHF) following routine post-casting radiographic assessment. We hypothesized that no cases would convert to operative management following one-week post-casting alignment assessments.
Methods: This single-center retrospective study focused on pediatric patients diagnosed with type IIA SCHF from 2019 to 2022.
Iowa Orthop J
January 2025
Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, New York, USA.
Background: While prolonged operative time and increased levels fused have been shown to increase the risk of prolonged intensive care unit (ICU) length-of-stay (LOS), studies are limited in guiding decision-making regarding the need for intensive care postoperatively. This is especially the case among the cohort of adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF); associations between comorbidities and ICU LOS are not well-delineated.
Methods: AIS patients who underwent PSF from January 1st, 2016 to December 1st, 2016 at 101 participating centers were identified using the American College of Surgeons (ACS) National Surgical Quality Im-provement Project (NSQIP) Pediatric database.
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