High-performance pediatric surgical risk calculator: A novel algorithm based on machine learning and pediatric NSQIP data

Abstract

BackgroundsNew methods such as machine learning could provide accurate predictions with little statistical assumptions. We seek to develop prediction model of pediatric surgical complications based on pediatric National Surgical Quality Improvement Program(NSQIP). MethodsAll 2012–2018 pediatric-NSQIP procedures were reviewed. Primary outcome was defined as 30-day post-operative morbidity/mortality. Morbidity was further classified as any, major and minor. Models were developed using 2012–2017 data. 2018 data was used as independent performance evaluation. Results431,148 patients were included in the 2012–2017 training and 108,604 were included in the 2018 testing set. Our prediction models had high performance in mortality prediction at 0.94 AUC in testing set. Our models outperformed ACS-NSQIP Calculator in all categories for morbidity (0.90 AUC for major, 0.86 AUC for any, 0.69 AUC in minor complications). ConclusionsWe developed a high-performing pediatric surgical risk prediction model. This powerful tool could potentially be used to improve the surgical care quality.