Risk prediction model for postoperative cognitive dysfunction after total knee replacement based on Bayesian network algorithm

Objective To establish a prediction model of risk for postoperative cognitive dysfunction (POCD) after total knee replacement (TKR) by Bayesian network (BN) algorithm and investigate its predictive performance. Methods A case-control trial was conducted on 1 260 inpatients who underwent TKR from Jan...

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Main Authors: LI Danfeng, LI Haoyang, ZHONG Kunhua, SHU Xin, LI Yujie
Format: Article
Language:zho
Published: Editorial Office of Journal of Army Medical University 2023-04-01
Series:陆军军医大学学报
Subjects:
Online Access:http://aammt.tmmu.edu.cn/html/202301054.htm
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author LI Danfeng
LI Haoyang
ZHONG Kunhua
SHU Xin
LI Yujie
author_facet LI Danfeng
LI Haoyang
ZHONG Kunhua
SHU Xin
LI Yujie
author_sort LI Danfeng
collection DOAJ
description Objective To establish a prediction model of risk for postoperative cognitive dysfunction (POCD) after total knee replacement (TKR) by Bayesian network (BN) algorithm and investigate its predictive performance. Methods A case-control trial was conducted on 1 260 inpatients who underwent TKR from January 2017 to December 2021 in the Department of Joint Surgery of our hospital. Their main diagnosis of inclusion was severe osteoarthritis of left/right knee joint. They were 240 cases of male (19.0%) and 1 020 cases of female (81.0%), at an average age of 66.73±8.46 (23~79) years and a mean body mass index (BMI) of 25.08±5.08 kg/m2. The POCD patients (n=71) after surgery (from the end of surgery to discharge) were randomly divided into A1 group and B1 group at a ratio of 7∶3, and those without POCD (1 189 cases) were also randomly divided into A2 group and B2 group at a same ratio. The patients from A1 and A2 groups were combined together as training set, and those out of B1 and B2 groups as test set. Thirty-six indexes related to perioperative anesthesia decision, disease outcome and length of stay in TKR were selected as nodes, and the probability distribution model diagram of each node was established by using BN algorithm to predict the probability of risk for POCD, so as to minimize the length of stay and promote the maximum recovery of patients. Results The prediction model of risk for POCD after TKR was established based on BN algorithm. The area value under receiver operating characteristic curve (ROC-AUC) of the training set was 0.966 1 (95% CI: 0.954 1~0.978 4), and the ROC-AUC value of the test set was 0.897 4 (95% CI: 0.867 2~0.928 5), with an accuracy of 96.43% (95%CI: 0.951 1~0.976 4) and 93.44% (95% CI: 0.909 2~0.959 6), respectively. Conclusion Our risk prediction model for POCD after TKR based on BN algorithm has good performance and high accuracy
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spelling doaj.art-0fba0f53ebd3450a946b3e4cb9c87c662023-05-06T00:04:17ZzhoEditorial Office of Journal of Army Medical University陆军军医大学学报2097-09272023-04-0145876577110.16016/j.2097-0927.202301054Risk prediction model for postoperative cognitive dysfunction after total knee replacement based on Bayesian network algorithmLI Danfeng0LI Haoyang1ZHONG Kunhua2SHU Xin3 LI Yujie4Department of Anesthesiology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038Regiment Five, Basical Medicine College, Army Medical University (Third Military Medical University), Chongqing, 400038Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences, Chongqing, 400714, ChinaDepartment of Anesthesiology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038Department of Anesthesiology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038Objective To establish a prediction model of risk for postoperative cognitive dysfunction (POCD) after total knee replacement (TKR) by Bayesian network (BN) algorithm and investigate its predictive performance. Methods A case-control trial was conducted on 1 260 inpatients who underwent TKR from January 2017 to December 2021 in the Department of Joint Surgery of our hospital. Their main diagnosis of inclusion was severe osteoarthritis of left/right knee joint. They were 240 cases of male (19.0%) and 1 020 cases of female (81.0%), at an average age of 66.73±8.46 (23~79) years and a mean body mass index (BMI) of 25.08±5.08 kg/m2. The POCD patients (n=71) after surgery (from the end of surgery to discharge) were randomly divided into A1 group and B1 group at a ratio of 7∶3, and those without POCD (1 189 cases) were also randomly divided into A2 group and B2 group at a same ratio. The patients from A1 and A2 groups were combined together as training set, and those out of B1 and B2 groups as test set. Thirty-six indexes related to perioperative anesthesia decision, disease outcome and length of stay in TKR were selected as nodes, and the probability distribution model diagram of each node was established by using BN algorithm to predict the probability of risk for POCD, so as to minimize the length of stay and promote the maximum recovery of patients. Results The prediction model of risk for POCD after TKR was established based on BN algorithm. The area value under receiver operating characteristic curve (ROC-AUC) of the training set was 0.966 1 (95% CI: 0.954 1~0.978 4), and the ROC-AUC value of the test set was 0.897 4 (95% CI: 0.867 2~0.928 5), with an accuracy of 96.43% (95%CI: 0.951 1~0.976 4) and 93.44% (95% CI: 0.909 2~0.959 6), respectively. Conclusion Our risk prediction model for POCD after TKR based on BN algorithm has good performance and high accuracy http://aammt.tmmu.edu.cn/html/202301054.htmbayesian networkartificial intelligenceprediction modelpostoperative cognitive dysfunctiontotal knee replacement
spellingShingle LI Danfeng
LI Haoyang
ZHONG Kunhua
SHU Xin
LI Yujie
Risk prediction model for postoperative cognitive dysfunction after total knee replacement based on Bayesian network algorithm
陆军军医大学学报
bayesian network
artificial intelligence
prediction model
postoperative cognitive dysfunction
total knee replacement
title Risk prediction model for postoperative cognitive dysfunction after total knee replacement based on Bayesian network algorithm
title_full Risk prediction model for postoperative cognitive dysfunction after total knee replacement based on Bayesian network algorithm
title_fullStr Risk prediction model for postoperative cognitive dysfunction after total knee replacement based on Bayesian network algorithm
title_full_unstemmed Risk prediction model for postoperative cognitive dysfunction after total knee replacement based on Bayesian network algorithm
title_short Risk prediction model for postoperative cognitive dysfunction after total knee replacement based on Bayesian network algorithm
title_sort risk prediction model for postoperative cognitive dysfunction after total knee replacement based on bayesian network algorithm
topic bayesian network
artificial intelligence
prediction model
postoperative cognitive dysfunction
total knee replacement
url http://aammt.tmmu.edu.cn/html/202301054.htm
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AT lihaoyang riskpredictionmodelforpostoperativecognitivedysfunctionaftertotalkneereplacementbasedonbayesiannetworkalgorithm
AT zhongkunhua riskpredictionmodelforpostoperativecognitivedysfunctionaftertotalkneereplacementbasedonbayesiannetworkalgorithm
AT shuxin riskpredictionmodelforpostoperativecognitivedysfunctionaftertotalkneereplacementbasedonbayesiannetworkalgorithm
AT liyujie riskpredictionmodelforpostoperativecognitivedysfunctionaftertotalkneereplacementbasedonbayesiannetworkalgorithm