Predicting reoperation and readmission for head and neck free flap patients using machine learning

Head Neck. 2024 Aug;46(8):1999-2009. doi: 10.1002/hed.27690. Epub 2024 Feb 15.

Abstract

Background: To develop machine learning (ML) models predicting unplanned readmission and reoperation among patients undergoing free flap reconstruction for head and neck (HN) surgery.

Methods: Data were extracted from the 2012-2019 NSQIP database. eXtreme Gradient Boosting (XGBoost) was used to develop ML models predicting 30-day readmission and reoperation based on demographic and perioperative factors. Models were validated using 2019 data and evaluated.

Results: Four-hundred and sixty-six (10.7%) of 4333 included patients were readmitted within 30 days of initial surgery. The ML model demonstrated 82% accuracy, 63% sensitivity, 85% specificity, and AUC of 0.78. Nine-hundred and four (18.3%) of 4931 patients underwent reoperation within 30 days of index surgery. The ML model demonstrated 62% accuracy, 51% sensitivity, 64% specificity, and AUC of 0.58.

Conclusion: XGBoost was used to predict 30-day readmission and reoperation for HN free flap patients. Findings may be used to assist clinicians and patients in shared decision-making and improve data collection in future database iterations.

Keywords: healthcare quality assessments; machine learning; microvascular reconstruction.

MeSH terms

  • Adult
  • Aged
  • Databases, Factual
  • Female
  • Free Tissue Flaps*
  • Head and Neck Neoplasms* / surgery
  • Humans
  • Machine Learning*
  • Male
  • Middle Aged
  • Patient Readmission* / statistics & numerical data
  • Plastic Surgery Procedures* / methods
  • Postoperative Complications / epidemiology
  • Reoperation* / statistics & numerical data
  • Retrospective Studies