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Regression Models to Study Emergency Surgery Admissions

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Biomedical and Computational Biology (BECB 2022)

Abstract

In the last few decades there has been considerable interest in facing the challenging problem of improving emergency general surgery management.

The most crowded wards is the emergency one, especially due to population aging which results in higher mortality rates and prolonged hospital stay (LOS) w.r.t. the elective surgery intervention. This is mostly due to the intrinsic stochastic nature of patience arrival, and the heterogeneity of the medical procedures required. In this context, our work aims at reducing the LOS by using predictive algorithms to improve the emergency department management. In particular, we examine the LOS variation for cholecystectomy interventions in the emergency general surgery through three different machine learning algorithms and the linear regression analysis, with the purpose of identifying the best prediction model as long as those factors that have the highest contribution in enhancing the LOS, in order to reduce it and improve both the subject satisfaction and the overall quality of the provided health services.

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References

  1. Stewart, B., et al.: Global disease burden of conditions requiring emergency surgery. Br. J. Surg. 101, e9-22 (2014)

    Article  CAS  PubMed  Google Scholar 

  2. Shah, A.A., et al.: National estimates of predictors of outcomes for emergency general surgery. J. Trauma Acute Care Surg. 78, 482–90 (2015). discussion 490–491

    Google Scholar 

  3. Havens, J.M., et al.: The excess morbidity and mortality of emergency general surgery. J. Trauma Acute Care Surg. 78, 306–311 (2015)

    Article  PubMed  Google Scholar 

  4. Shafi, S., et al.: AAST committee on severity assessment and patient outcomes 2013 emergency general surgery: definition and estimated burden of disease. J. Trauma Acute Care Surg. 74, 1092–7

    Google Scholar 

  5. Di Saverio, S., et al.: The NOTA study (non operative treatment for acute appendicitis): prospective study on the efficacy and safety of antibiotics (amoxicillin and clavulanic acid) for treating patients with right lower quadrant abdominal pain and long-term follow-up of conservatively treated suspected appendicitis. Ann. Surg. 260, 109–117 (2014)

    Article  PubMed  Google Scholar 

  6. Papandria, D., et al.: Risk of perforation increases with delay in recognition and surgery for acute appendicitis. J. Surg. Res. 184, 723–729 (2013)

    Article  PubMed  Google Scholar 

  7. Liang, M.K., Lo, H.G., Marks, J.L.: Stump appendicitis: a comprehensive review of literature. Am. Surg. 72, 162–166 (2006)

    Article  PubMed  Google Scholar 

  8. Smeraglia, F., Basso, M.A., Famiglietti, G., Eckersley, R., Bernasconi, A., Balato, G.: Partial wrist denervation versus total wrist denervation: a systematic review of the literature. Hand Surg. Rehabil. 39(6), 487–491 (2020)

    Article  CAS  PubMed  Google Scholar 

  9. Smeraglia, F., Del Buono, A., Maffulli, N.: Endoscopic cubital tunnel release: a systematic review. Br. Med. Bull. 116, 155–163 (2015)

    PubMed  Google Scholar 

  10. Smeraglia, F., Mariconda, M., Balato, G., Di Donato, S.L., Criscuolo, G., Maffulli, N.: Dubious space for artelon joint resurfacing for basal thumb (trapeziometacarpal joint) osteoarthritis. A Syst. Rev. Br. Med. Bull. 126(1), 79–84 (2018)

    Article  Google Scholar 

  11. Achanta, A., et al.: Most of the variation in length of stay in emergency general surgery is not related to clinical factors of patient care. J. Trauma Acute Care Surg. 87, 408–412 (2019)

    Article  PubMed  Google Scholar 

  12. Shojania, K.G., Showstack, J., Wachter, R.M.: Assessing hospital quality: a review for clinicians Eff. Clin. Pract. ECP 4, 82–90 (2001)

    CAS  PubMed  Google Scholar 

  13. Adogwa, O., et al.: Extended length of stay in elderly patients after anterior cervical discectomy and fusion is not attributable to baseline illness severity or postoperative complications. World Neurosurg. 115, e552–e557 (2018)

    Article  PubMed  Google Scholar 

  14. Detsky, A.S., Stricker, S.C., Mulley, A.G., Thibault, G.E.: Prognosis, survival, and the expenditure of hospital resources for patients in an intensive-care unit. N. Engl. J. Med. 305, 667–672 (1981)

    Article  CAS  PubMed  Google Scholar 

  15. Bernasconi, A., Sadile, F., Smeraglia, F., Mehdi, N., Laborde, J., Lintz, F.: Tendoscopy of achilles, peroneal and tibialis posterior tendons: an evidence-based update. Foot Ankle Surg. 24(5), 374–382 (2018)

    Article  PubMed  Google Scholar 

  16. Smeraglia, F., Tamborini, F., Garutti, L., Minini, A., Basso, M.A., Cherubino, M.: Chronic exertional compartment syndrome of the forearm: a systematic review. EFORT Open Rev. 6(2), 101–106 (2021)

    Article  PubMed  PubMed Central  Google Scholar 

  17. Molloy, I.B., Martin, B.I., Moschetti, W.E., Jevsevar, D.S.: Effects of the length of stay on the cost of total knee and total hip arthroplasty from 2002 to 2013. J. Bone Joint Surg. Am. 99, 402–407 (2017)

    Article  PubMed  PubMed Central  Google Scholar 

  18. Darrith, B., Frisch, N.B., Tetreault, M.W., Fice, M.P., Culvern, C.N., Della Valle, C.J.: Inpatient versus outpatient arthroplasty: a single-surgeon, matched cohort analysis of 90-day complications. J. Arthroplasty 34, 221–227 (2019)

    Article  PubMed  Google Scholar 

  19. Han, Q., Molinaro, C., Picariello, A., Sperli, G., Subrahmanian, V.S., Xiong, Y.: Generating fake documents using probabilistic logic graphs. IEEE Trans. Dependable Secure Comput. (2021). https://doi.org/10.1109/TDSC.2021.3058994

  20. La Gatta, V., Moscato, V., Pennone, M., Postiglione, M., Sperlí, G.: Music recommendation via hypergraph embedding. IEEE Trans. Neural Netw. Learn. Syst. (2022). https://doi.org/10.1109/TNNLS.2022.3146968

  21. Esposito, C., Moscato, V., Sperlí, G.: Trustworthiness assessment of users in social reviewing systems. IEEE Trans. Syst. Man Cybern. Syst. 52(1), 151–165 (2022). https://doi.org/10.1109/TSMC.2020.3049082

    Article  Google Scholar 

  22. Sperlí, G.: A deep learning based chatbot for cultural heritage. In: Proceedings of the 35th Annual ACM Symposium on Applied Computing, pp. 935–937, March 2020. https://doi.org/10.1145/3341105.3374129

  23. Ianni, M., Masciari, E., Sperlí, G.: A survey of big data dimensions vs social networks analysis. J. Intell. Inf. Syst. 57(1), 73–100 (2020). https://doi.org/10.1007/s10844-020-00629-2

    Article  PubMed  PubMed Central  Google Scholar 

  24. Sperlí, G.: A cultural heritage framework using a deep learning based chatbot for supporting tourist journey. Expert Syst. Appl. 183, 115277 (2021). https://doi.org/10.1016/j.eswa.2021.115277

    Article  Google Scholar 

  25. Carter, E.M., Potts, H.W.W.: Predicting length of stay from an electronic patient record system: a primary total knee replacement example. BMC Med. Inform. Decis. Mak. 14, 26 (2014)

    Article  PubMed  PubMed Central  Google Scholar 

  26. Cesarelli, G., Scala, A., Vecchione, D., Ponsiglione, A.M., Guizzi, G.: An innovative business model for a multi-echelon supply chain inventory management pattern. In: Journal of Physics: Conference Series, vol. 1828, no. 1, p. 012082. IOP Publishing, February 2021

    Google Scholar 

  27. Ponsiglione, A.M., Cosentino, C., Cesarelli, G., Amato, F., Romano, M.: A comprehensive review of techniques for processing and analyzing fetal heart rate signals. Sensors 21(18), 6136 (2021)

    Article  PubMed  PubMed Central  Google Scholar 

  28. Trunfio, T.A., Scala, A., Vecchia, A.D., Marra, A., Borrelli, A.: Multiple regression model to predict length of hospital stay for patients undergoing femur fracture surgery at “san giovanni di dio e ruggi d’aragona” university hospital. In: Jarm, T., Cvetkoska, A., Mahnič-Kalamiza, S., Miklavcic, D. (eds.) 8th European Medical and Biological Engineering Conference. EMBEC 2020. IFMBE Proceedings, vol. 80, pp 840–7. Springer, Cham (2021). https://doi.org/10.1007/978-3-030-64610-3_94

  29. Ponsiglione, A.M., Romano, M., Amato, F.: A finite-state machine approach to study patients dropout from medical examinations. In: 2021 IEEE 6th International Forum on Research and Technology for Society and Industry (RTSI), pp. 289–294. IEEE, September 2021

    Google Scholar 

  30. Park, C., Took, C.C., Seong, J.-K.: Machine learning in biomedical engineering. Biomed. Eng. Lett. 8(1), 1–3 (2018). https://doi.org/10.1007/s13534-018-0058-3

    Article  PubMed  PubMed Central  Google Scholar 

  31. Ponsiglione, A.M., Amato, F., Cozzolino, S., Russo, G., Romano, M., Improta, G.: A hybrid analytic hierarchy process and likert scale approach for the quality assessment of medical education programs. Mathematics 10(9), 1426 (2022)

    Article  Google Scholar 

  32. Majolo, M., et al.: Studying length of stay in the emergency department of AORN “Antonio Cardarelli” of Naples. In: 2021 10th International Conference on Bioinformatics and Biomedical Science, pp. 144–147, October 2021

    Google Scholar 

  33. Combes, C., Kadri, F., Chaabane S.: Predicting hospital length of stay using regression models: application to emergency department (2014)

    Google Scholar 

  34. Al Taleb, A.R., Hoque, M., Hasanat, A., Khan, M.B.: Application of data mining techniques to predict length of stay of stroke patients. In: 2017 International Conference on Informatics, Health Technology (ICIHT) 2017 International Conference on Informatics, Health Technology (ICIHT), pp. 1–5 (2017)

    Google Scholar 

  35. De Franco, C., et al.: The active knee extension after extensor mechanism reconstruction using allograft is not influenced by “early mobilization”: a systematic review and meta-analysis. J. Orthop. Surg. Res. 17(1), 153 (2022)

    Article  PubMed  PubMed Central  Google Scholar 

  36. Balato, G., et al.: Bacterial biofilm formation is variably inhibited by different formulations of antibiotic-loaded bone cement in vitro. Knee Surg. Sports Traumatol. Arthrosc. 27(6), 1943–1952 (2018). https://doi.org/10.1007/s00167-018-5230-x

    Article  PubMed  Google Scholar 

  37. Ascione, T., et al.: Clinical and microbiological outcomes in haematogenous spondylodiscitis treated conservatively. Eur. Spine J. 26(4), 489–495 (2017). https://doi.org/10.1007/s00586-017-5036-4

    Article  PubMed  Google Scholar 

  38. Balato, G., et al.: Hip and knee section, prevention, surgical technique: proceedings of international consensus on orthopedic infections. J. Arthroplasty 34(2S), S301–S307 (2019)

    Google Scholar 

  39. Romano, V., et al.: Cell toxicity study of antiseptic solutions containing povidone-iodine and hydrogen peroxide. Diagnostics (Basel) 12(8), 2021 (2022)

    Article  CAS  PubMed  Google Scholar 

  40. Balato, G., Rizzo, M., Ascione, T., Smeraglia, F., Mariconda, M.: Re-infection rates and clinical outcomes following arthrodesis with intramedullary nail and external fixator for infected knee prosthesis: a systematic review and meta-analysis. BMC Musculoskelet Disord. 19(1), 361 (2018)

    Article  PubMed  PubMed Central  Google Scholar 

  41. Bender, G.J., et al.: Neonatal intensive care unit: predictive models for length of stay. J. Perinatol. Off. J. Calif. Perinat. Assoc. 33, 147–153 (2013)

    CAS  Google Scholar 

  42. Bacchi, S., Tan, Y., Oakden-Rayner, L., Jannes, J., Kleinig, T., Koblar, S.: Machine Learning in the Prediction of Medical Inpatient Length of Stay Intern. Med. J. n/a

    Google Scholar 

  43. Borghans, I., Kool, R.B., Lagoe, R.J., Westert, G.P.: Fifty ways to reduce length of stay: an inventory of how hospital staff would reduce the length of stay in their hospital. Health Policy 104, 222–233 (2012)

    Article  PubMed  Google Scholar 

  44. Scala, A., et al.: Lean six sigma approach for reducing length of hospital stay for patients with femur fracture in a university hospital. Int. J. Environ. Res. Public. Health 18, 2843 (2021)

    Article  PubMed  PubMed Central  Google Scholar 

  45. Scala, A., Trunfio, T.A., Vecchia, A.D., Marra, A., Borrelli, A.: Lean six sigma approach to implement a femur fracture care pathway at “san giovanni di dio e ruggi d’aragona” university hospital. In: Jarm, T., Cvetkoska, A., Mahnič-Kalamiza, S., Miklavcic, D. (eds.) 8th European Medical and Biological Engineering Conference. EMBEC 2020. IFMBE Proceedings, vol. 80, pp. 740–749. Springer, Cham (2021). https://doi.org/10.1007/978-3-030-64610-3_83

  46. Pearson, S.D., Kleefield, S.F., Soukop, J.R., Cook, E.F., Lee, T.H.: Critical pathways intervention to reduce length of hospital stay. Am. J. Med. 110, 175–180 (2001)

    Article  CAS  PubMed  Google Scholar 

  47. Lauck, S.B., et al.: Vancouver transcatheter aortic valve replacement clinical pathway: minimalist approach, standardized care, and discharge criteria to reduce length of stay. Circ. Cardiovasc. Qual. Outcomes 9, 312–321 (2016)

    Article  PubMed  Google Scholar 

  48. Improta, G., et al.: Lean thinking to improve emergency department throughput at AORN Cardarelli hospital. BMC Health Serv. Res. 18, 914 (2018)

    Article  PubMed  PubMed Central  Google Scholar 

  49. Latessa, I., et al.: Implementing fast track surgery in hip and knee arthroplasty using the lean Six Sigma methodology. TQM J. 33, 131–147 (2021)

    Article  Google Scholar 

  50. Scala, A., Trunfio, T.A., Borrelli, A., Ferrucci, G., Triassi, M., Improta, G.: Modelling the hospital length of stay for patients undergoing laparoscopic cholecystectomy through a multiple regression model. In: 2021 5th International Conference on Medical and Health Informatics, pp. 68–72, May 2021

    Google Scholar 

  51. Stocker, B., Weiss, H.K., Weingarten, N., Engelhardt, K., Engoren, M., Posluszny, J.: Predicting length of stay for trauma and emergency general surgery patients. Am. J. Surg. 220, 757–764 (2020)

    Article  PubMed  Google Scholar 

  52. Chatterjee, S., Hadi, A.S.: Influential observations, high leverage points, and outliers in linear regression. Stat. Sci. 1, 379–393 (1986)

    Google Scholar 

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Correspondence to Marta Rosaria Marino .

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Profeta, M. et al. (2023). Regression Models to Study Emergency Surgery Admissions. In: Wen, S., Yang, C. (eds) Biomedical and Computational Biology. BECB 2022. Lecture Notes in Computer Science(), vol 13637. Springer, Cham. https://doi.org/10.1007/978-3-031-25191-7_51

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  • DOI: https://doi.org/10.1007/978-3-031-25191-7_51

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