arXiv:2602.02517cs.LGcs.AI2026-02

机器学习可精准预测脊柱手术住院时长,助力医院资源管理。

What Drives Length of Stay After Elective Spine Surgery? Insights from a Decade of Predictive Modeling

  • 用机器学习模型预测术后住院天数,优于传统统计方法。
  • 模型AUC达0.94至0.99,年龄、糖尿病等是关键预测因子。
  • 适合关注临床决策支持与医疗资源优化的研究者。

目的:预测择期脊柱手术患者的住院时长对于优化患者预后和医院资源配置至关重要。本系统综述总结了用于预测该人群住院时长的计算方法,突出显示模型性能与关键预测因子。方法:遵循PRISMA指南,系统检索了2015年12月1日至2024年12月1日间发表于PubMed、Google Scholar和ACM Digital Library的研究。纳入标准为应用统计或机器学习模型预测择期脊柱手术患者住院时长的研究。三位评审员独立筛选文献并提取数据。结果:共筛选1,263篇研究,29篇符合纳入标准。住院时长被建模为连续变量、二分类或分位数结果。模型包括逻辑回归、随机森林、提升算法和神经网络。机器学习模型表现持续优于传统统计模型,AUC范围为0.94至0.99。在部分研究中,K-近邻和朴素贝叶斯表现最佳。常见预测因子包括年龄、合并症(特别是高血压和糖尿病)、体重指数(BMI)、手术类型与持续时间、手术节段数量。然而,外部验证和报告实践在各研究间差异显著。讨论:人工智能与机器学习在住院时长预测中兴趣日益增长,但缺乏标准化与外部验证限制了其临床实用性。未来研究应优先采用标准化结局定义与透明报告,以推动实际部署。结论:机器学习模型在预测择期脊柱手术后住院时长方面具有强大潜力,有助于改善出院规划与医院资源管理。

原文摘要 · Abstract (English)

Objective: Predicting length of stay after elective spine surgery is essential for optimizing patient outcomes and hospital resource use. This systematic review synthesizes computational methods used to predict length of stay in this patient population, highlighting model performance and key predictors. Methods: Following PRISMA guidelines, we systematically searched PubMed, Google Scholar, and ACM Digital Library for studies published between December 1st, 2015, and December 1st, 2024. Eligible studies applied statistical or machine learning models to predict length of stay for elective spine surgery patients. Three reviewers independently screened studies and extracted data. Results: Out of 1,263 screened studies, 29 studies met inclusion criteria. Length of stay was predicted as a continuous, binary, or percentile-based outcome. Models included logistic regression, random forest, boosting algorithms, and neural networks. Machine learning models consistently outperformed traditional statistical models, with AUCs ranging from 0.94 to 0.99. K-Nearest Neighbors and Naive Bayes achieved top performance in some studies. Common predictors included age, comorbidities (notably hypertension and diabetes), BMI, type and duration of surgery, and number of spinal levels. However, external validation and reporting practices varied widely across studies. Discussion: There is growing interest in artificial intelligence and machine learning in length of stay prediction, but lack of standardization and external validation limits clinical utility. Future studies should prioritize standardized outcome definitions and transparent reporting needed to advance real-world deployment. Conclusion: Machine learning models offer strong potential for length of stay prediction after elective spine surgery, highlighting their potential for improving discharge planning and hospital resource management.

住院时长机器学习临床预测医疗资源

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