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Objective:To investigate the analysis of postoperative death in patients with Stanford B acute aortic dissection (AAD) by XGBoost model.Methods:A retrospective study was conducted on 226 patients with Stanford type B AAD diagnosed in Yunnan Wenshan People′s Hospital from February 2012 to June 2019, including 126 males and 100 females, with an average age of (61.24±4.25) years. According to the outcome of discharge, the patients were divided into survival group ( n=129) and death group ( n=97), in which those who automatically gave up treatment and left the hospital were regarded as the death group. If the patients were admitted to Yunnan Wenshan People′s Hospital for many times during the study period, only the clinical data diagnosed as Stanford B AAD for the first time were selected for the study. The clinical data and hematological indexes of the subjects were collected, and the XGBoost model was used to predict the rapid diagnosis of postoperative death in patients with Stanford B AAD, and compared with the traditional Logistic regression model. Results:In the XGBoost model, the influencing factors were ranked according to the degree of importance. The top 6 factors were hypertension, neutrophil-to-lymphocyte(NLR), C-reactive protein (CRP), white blood cell count(WBC), D-dimer and heart rate. Hypertension and NLR had the greatest influence on postoperative death in patients with Stanford B AAD. Using receiver operator charateristic curve to compare the prediction performance of the two models, it was found that the prediction efficiency of the XGBoost algorithm was significantly stronger than that of the Logistic regression model in the training set, while the two models were equivalent in the verification set. The prediction models constructed by the two methods eventually included independent variables such as hypertension, NLR, CRP, WBC, D-dimer, heart rate, systolic blood pressure, diastolic blood pressure, surgical treatment and so on.Conclusions:XGBoost model can be used to predict the postoperative death of patients with Stanford B AAD. Its diagnostic performance is better than Logistic regression model in training set and equivalent to the latter in verification set. Hypertension and NLR are the most important predictors of postoperative mortality in patients with Stanford B type AAD.
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Objective To study the risky factors related to postoperative mortality after surgical intervention for intra-ventricular hemorrhage (IVH).Methods The clinical data of 142 IVH patients aged from 19 to 86 years with 77 male and 65 female were collected from 2007 to 2010 for retrospective analysis with SPSS version 13.0 package.Multi-factorial Logistic regression analysis and mono-factorial x2 analysis were used to find out the risk factors related to post-operative death. Results Of 142 patients,48 (33.8％) died.Mono-factorial analysis demonstrated that the risk factors of death after surgical intervention to IVH were elderly age ( ＞ 65 years),history of hypertension,low GGS score,intra-ventricular diffuse bleeding,preoperative obstructive hydrocephalus and coagulation abnormality,postoperative central high pyrexia and central diabetes insipidus,postoperative hemorrhage of alimentary tract,pulmonary infection,and drainage after operation ≥7 days ( P ＜ 0.05 or P ＜ 0.01 ).Multi-factorial Logistic regression analysis,on the other hand,revealed the independent factors associated with postoperative IVH mortality were postoperative central high fever,preoperative obstructive hydrocephalus (P ＜ 0.01 ); drainage after operation ≥7 days,postoperative pulmonary infection,elderly age,low GCS score,intra-ventricular diffuse bleeding and history of hypertension ( P ＜ 0.05 ). Conclusions General condition of patients with IVH and CT findings are likely related to mortality,and active prevention against various complications is the crucial approach to lowering postoperative mortality and improving prognosis.
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BACKGROUND: A retrospective study was performed to evaluate postoperative mortality within 30 days following surgery. METHODS: The records of 31,806 patients who received operation under general anesthesia were reviewed. RESULTS: 1) Postoperative deaths were 184 cases, the ratio of which was comprising 0.57% of all surgical operative cases. 2) The highest ratio of the mortality in age group was 51~60 years group which was 24.5%, and in physical status it was ASA class III which was 36.4%. The highest ratio to the mortality rate in postoperative days was 8~30 days which was 45.1%. 3) The most common causes of death was low cardiac output due to heart failure on operating theater, and hypovolemic shock within postoperative 2 days, and intracranial problem within postoperative 7 days, and pulmonary complication within postoperative 30 days. CONCLUSION: We conclude that fatality rate could be decreased by intensive and multidisciplinary care for postoperaive complications as respiratory and renal failure.