Neural networks as a prognostic tool of surgical risk in lung resections.
BACKGROUND
Assessment of surgical risk in patients undergoing pulmonary resection is a fundamental goal for thoracic surgeons. Usually used risk indices do not predict the individual outcome. Neural networks (NN) are artificial intelligence software models that have been used for estimation of several prognostic situations.


METHODS
Ninety-six clinical and laboratory features from each one of 141 patients who underwent lung resection were retrospectively collected. The variables were used as input data for the software. Cases were divided into a training set (n = 113) and a test set (n = 28). Four NN models were trained using the data from the training set: (1) using all variables; (2) using only the Goldman and Torrington scores; (3) using all variables except for the two scores. A fourth NN was programmed with all variables to estimate the development of major postoperative complications. The trained NN models were tested with the test set data.


RESULTS
The NN using all variables with or without the scores were able to correctly classify all 28 test cases against actual outcome. The NN using all variables also estimated major postoperative complications correctly in all 28 test cases. The NN using only two indices (Goldman and Torrington) yielded 6 of 28 errors in classification.


CONCLUSIONS
These data suggest that NN can integrate results from multiple data predicting the individual outcome for patients, rather than assigning them to less-precise risk group categories.
Esteva
Hugo
H
Division of Thoracic Surgery, Hospital de Clínicas José de San Martín, University of Buenos Aires, Argentina. hesteva@intramed.net.ar
Marchevsky
Alberto
A
Núñez
Tomás
T
Luna
Carlos
C
Esteva
Mercedes
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016571:Neural Networks, Computer; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D012306:Risk; D015996:Survival Rate