Machine learning with clinical and intraoperative biosignal data for predicting postoperative delirium after cardiac surgery
Changho Han,
Hyun Il Kim,
Sarah Soh,
Ja Woo Choi,
Jong Wook Song,
Dukyong Yoon
Affiliations
Changho Han
Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Yongin, Republic of Korea
Hyun Il Kim
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute Yonsei University College of Medicine, Seoul, Republic of Korea
Sarah Soh
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute Yonsei University College of Medicine, Seoul, Republic of Korea
Ja Woo Choi
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute Yonsei University College of Medicine, Seoul, Republic of Korea
Jong Wook Song
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute Yonsei University College of Medicine, Seoul, Republic of Korea; Corresponding author
Dukyong Yoon
Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Yongin, Republic of Korea; Center for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin, Republic of Korea; Institute for Innovation in Digital Healthcare (IIDH), Severance Hospital, Seoul, Republic of Korea; Corresponding author
Summary: Early identification of patients at high risk of delirium is crucial for its prevention. Our study aimed to develop machine learning models to predict delirium after cardiac surgery using intraoperative biosignals and clinical data. We introduced a novel approach to extract relevant features from continuously measured intraoperative biosignals. These features reflect the patient’s overall or baseline status, the extent of unfavorable conditions encountered intraoperatively, and beat-to-beat variability within the data. We developed a soft voting ensemble machine learning model using retrospective data from 1,912 patients. The model was then prospectively validated with data from 202 additional patients, achieving a high performance with an area under the receiver operating characteristic curve of 0.887 and an accuracy of 0.881. According to the SHapley Additive exPlanation method, several intraoperative biosignal features had high feature importance, suggesting that intraoperative patient management plays a crucial role in preventing delirium after cardiac surgery.
