title: Predicting postoperative vomiting for orthopedic patients receiving patient-controlled epidural analgesia with the application of an artificial neural network.
abstract: Patient-controlled epidural analgesia (PCEA) was used in many patients receiving orthopedic surgery to reduce postoperative pain but is accompanied with certain incidence of vomiting. Predictions of the vomiting event, however, were addressed by only a few authors using logistic regression (LR) models. Artificial neural networks (ANN) are pattern-recognition tools that can be used to detect complex patterns within data sets. The purpose of this study was to develop the ANN based predictive model to identify patients with high risk of vomiting during PCEA used. From January to March 2007, the PCEA records of 195 patients receiving PCEA after orthopedic surgery were used to develop the two predicting models. The ANN model had a largest area under curve (AUC) in receiver operating characteristic (ROC) curve. The areas under ROC curves of ANN and LR models were 0.900 and 0.761, respectively. The computer-based predictive model should be useful in increasing vigilance in those patients most at risk for vomiting while PCEA is used, allowing for patient-specific therapeutic intervention, or even in suggesting the use of alternative methods of analgesia.
authors.affiliation: Department of Electrical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, Taoyuan 333, Taiwan ; Portable Energy System Group, Green Technology Research Center, College of Engineering, Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Cihun-Siyong Alex
authors.identifier: 0000-0001-9414-3798
authors.initials: CS
authors.lastname: Gong
authors.affiliation: Department of Biomedical Engineering, College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning 110001, China.
authors.forename: Lu
authors.identifier: 0000-0001-8872-2611
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, No. 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan.
authors.forename: Chien-Kun
authors.initials: CK
authors.lastname: Ting
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, No. 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan.
authors.forename: Mei-Yung
authors.identifier: 0000-0002-6740-4080
authors.initials: MY
authors.lastname: Tsou
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, No. 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan.
authors.forename: Kuang-Yi
authors.identifier: 0000-0003-3839-3738
authors.initials: KY
authors.lastname: Chang
authors.affiliation: Section of Anesthesiology, Ton-Yen General Hospital, Hsinchu 302, Taiwan.
authors.forename: Chih-Long
authors.identifier: 0000-0002-9042-1559
authors.initials: CL
authors.lastname: Shen
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, No. 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan.
authors.forename: Shih-Pin
authors.initials: SP
authors.lastname: Lin
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects*; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015233:Models, Statistical; D009415:Nerve Net; D016571:Neural Networks, Computer; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000139:chemically induced / Q000473:pathology; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000473:pathology