Predicting Postoperative Hospital Stays Using Nursing Narratives and the Reverse Time Attention (RETAIN) Model: Retrospective Cohort Study

Abstract

Abstract BackgroundNursing narratives are an intriguing feature in the prediction of short-term clinical outcomes. However, it is unclear which nursing narratives significantly impact the prediction of postoperative length of stay (LOS) in deep learning models. ObjectiveTherefore, we applied the Reverse Time Attention (RETAIN) model to predict LOS, entering nursing narratives as the main input. MethodsA total of 354 patients who underwent ovarian cancer surgery at the Seoul National University Bundang Hospital from 2014 to 2020 were retrospectively enrolled. Nursing narratives collected within 3 postoperative days were used to predict prolonged LOS (≥10 days). The physician’s assessment was conducted based on a retrospective review of the physician’s note within the same period of the data model used. ResultsThe model performed better than the physician’s assessment (area under the receiver operating curve of 0.81 vs 0.58; P ConclusionsThe use of the RETAIN model on nursing narratives predicted postoperative LOS effectively for patients who underwent ovarian cancer surgery. These findings suggest that accurate and interpretable deep learning information obtained shortly after surgery may accurately predict prolonged LOS.