Predicting prolonged postoperative ileus in gastric cancer patients based on bowel sounds using intelligent auscultation and machine learning  

作　　者：Shuai Shi Cong Lu Liang Shan Liang Yan Yong Liang Tao Feng Zun Chen Xin Chen Xi Wu Si-Da Liu Xiang-Long Duan Ze-Zheng Wang 

机构地区：[1]Second Department General Surgery,Shaanxi Provincial People's Hospital,Xi’an 710068,Shaanxi Province,China [2]Department of Gastrointestinal Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei Province,China [3]Institute of Navigation,Northwestern Polytechnical University,Xi’an 710072,Shaanxi Province,China [4]Electronics and Information Engineering,Xi'an Polytechnic University,Xi’an 710048,Shaanxi Province,China [5]Department of Medicine,Xi'an Jiao Tong University,Xi’an 710065,Shaanxi Province,China [6]Shaanxi Engineering Research Center of Medical Polymer Materials,Xi’an 710072,Shaanxi Province,China [7]Institute of Medical Research,Northwestern Polytechnical University,Xi’an 710072,Shaanxi Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第11期3484-3498,共15页世界胃肠外科杂志（英文）

基　　金：Supported by Key Research and Development Program of Shaanxi,No.2020GXLH-Y-019,No.2022KXJ-141,and No.2023-GHYB-11;Innovation Capability Support Program of Shaanxi,No.2019GHJD-14 and No.2021TD-40;Science and Technology Program of Xi'an,No.23ZDCYJSGG0037-2022.

摘　　要：BACKGROUND Prolonged postoperative ileus(PPOI)delays the postoperative recovery of gastrointestinal function in patients with gastric cancer(GC),leading to longer hospitalization and higher healthcare expenditure.However,effective monitoring of gastrointestinal recovery in patients with GC remains challenging because of AIM To explore the risk factors for delayed postoperative bowel function recovery and evaluate bowel sound indicators collected via an intelligent auscultation system to guide clinical practice.METHODS This study included data from 120 patients diagnosed with GC who had undergone surgical treatment and postoperative bowel sound monitoring in the Department of General Surgery II at Shaanxi Provincial People's Hospital between January 2019 and January 2021.Among them,PPOI was reported in 33 cases.The patients were randomly divided into the training and validation cohorts.Significant variables from the training cohort were identified using univariate and multivariable analyses and were included in the model.RESULTS The analysis identified six potential variables associated with PPOI among the included participants.The incidence rate of PPOI was 27.5%.Age≥70 years,cTNM stage(Ⅰ and Ⅳ),preoperative hypoproteinemia,recovery time of bowel sounds(RTBS),number of bowel sounds(NBS),and frequency of bowel sounds(FBS)were independent risk factors for PPOI.The Bayesian model demonstrated good performance with internal validation:Training cohort[area under the curve(AUC)=0.880,accuracy=0.823,Brier score=0.139]and validation cohort(AUC=0.747,accuracy=0.690,Brier score=0.215).The model showed a good fit and calibration in the decision curve analysis,indicating a significant net benefit.CONCLUSION PPOI is a common complication following gastrectomy in patients with GC and is associated with age,cTNM stage,preoperative hypoproteinemia,and specific bowel sound-related indices(RTBS,NBS,and FBS).To facilitate early intervention and improve patient outcomes,clinicians should consider these factors,optimize preoper

关 键 词：Bowel sounds Gastric cancer Prolonged postoperative ileus Intelligent auscultation Machine learning 

分 类 号：R574.2[医药卫生—消化系统]