Construction and verification of a machine learning-based prediction model of deep vein thrombosis formation after spinal surgery

Background: Deep vein thromboembolism (DVT) is a common postoperative complication with high morbidity and mortality rates. However, the safety and effectiveness of using prophylactic anticoagulants for preventing DVT after spinal surgery remain controversial. Hence, it is crucial to predict whether DVT occurs in advance following spinal surgery. The present study aimed to establish a machine learning (ML)-based prediction model of DVT formation following spinal surgery. Methods: We reviewed the medical records of patients who underwent elective spinal surgery at the Third Affiliated Hospital of Zunyi Medical University (TAHZMU) from January 2020 to December 2022. We ultimately selected the clinical data of 500 patients who met the criteria for elective spinal surgery. The Boruta-SHAP algorithm was used for feature selection, and the SMOTE algorithm was used for data balance. The related risk factors for DVT after spinal surgery were screened and analyzed. Five ML algorithm models were established. The data of 150 patients treated at the Affiliated Hospital of Zunyi Medical University (AHZMU) from July 2023 to October 2023 were used for external verification of the model. The area under the curve (AUC), geometric mean (G-mean), sensitivity, accuracy, specificity, and F1 score were used to evaluate the performance of the models. Results: The results revealed that activated partial thromboplastin time (APTT), age, body mass index (BMI), preoperative serum creatinine (Crea), anesthesia time, rocuronium dose, and propofol dose were the seven important characteristic variables for predicting DVT after spinal surgery. Among the five ML models established in this study, the random forest classifier (RF) showed superior performance to the other models in the internal validation set. Conclusion: Seven preoperative and intraoperative variables were included in our study to develop an ML-based predictive model for DVT formation following spinal surgery, and this model can be used to assist in clinical evaluation and decision-making.