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Using a Machine Learning Approach to Predict the Need for Elective Revision and Unplanned Surgery after Implant-based Breast Reconstruction.
Chen, Yunchan; Zhang, Ashley; Lu Wang, Marcos; Black, Grant G; Zhou, George; Otterburn, David M.
Afiliación
  • Chen Y; From Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, N.Y.
  • Zhang A; Division of Plastic and Reconstructive Surgery, Columbia University Irving Medical Center, New York, N.Y.
  • Lu Wang M; From Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, N.Y.
  • Black GG; From Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, N.Y.
  • Zhou G; From Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, N.Y.
  • Otterburn DM; From Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, N.Y.
Plast Reconstr Surg Glob Open ; 12(3): e5542, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38504940
ABSTRACT
Two-stage implant-based reconstruction after mastectomy may require secondary revision procedures to treat complications, correct defects, and improve aesthetic outcomes. Patients should be counseled on the possibility of additional procedures during the initial visit, but the likelihood of requiring another procedure is dependent on many patient- and surgeon-specific factors. This study aims to identify patient-specific factors and surgical techniques associated with higher rates of secondary procedures and offer a machine learning model to compute individualized assessments for preoperative counseling. A training set of 209 patients (406 breasts) who underwent two-stage alloplastic reconstruction was created, with 45.57% of breasts (185 of 406) requiring revisional or unplanned surgery. On multivariate analysis, hypertension, no tobacco use, and textured expander use corresponded to lower odds of additional surgery. In contrast, higher initial tissue expander volume, vertical radial incision, and larger nipple-inframammary fold distance conferred higher odds of additional surgery. The neural network model trained on clinically significant variables achieved the highest collective performance metrics, with ROC AUC of 0.74, sensitivity of 84.2, specificity of 63.6, and accuracy of 62.1. The proposed machine learning model trained on a single surgeon's data offers a precise and reliable tool to assess an individual patient's risk of secondary procedures. Machine learning models enable physicians to tailor surgical planning and empower patients to make informed decisions aligned with their lifestyle and preferences. The utilization of this technology is especially applicable to plastic surgery, where outcomes are subject to a variety of patient-specific factors and surgeon practices, including threshold to perform secondary procedures.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Plast Reconstr Surg Glob Open Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Plast Reconstr Surg Glob Open Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos