A Novel Machine Learning Model Developed to Assist in Patient Selection for Outpatient Total Shoulder Arthroplasty
Dustin R. Biron, BA,1,2 Ishan Sinha, BS,1,2 Justin E. Kleiner, MD,1 Dilum P. Aluthge, BS,1,2 Avi D. Goodman, MD,3 I. Neil Sarkar, PhD, MLIS,2 Eric Cohen, MD,3 and Alan H. Daniels, MD3Shoulder
Introduction:
Patient selection for outpatient total shoulder arthroplasty is important to optimizing patient outcomes. The goal of this study was to develop a machine learning tool that may aid in patient selection for outpatient total should arthroplasty based on medical comorbidities and demographic factors.
Methods:
Patients undergoing elective total shoulder arthroplasty from 2011–2016 in the National Surgical Quality Improvement Program were queried. A Random Forest machine learning model was used to predict which patients had a length of stay of 1 day or less (short stay). A multivariable logistic regression was then used to identify which variables were significantly correlated with a short or long stay.
Results:
From 2011–2016, 4,500 patients were identified as having undergone elective total shoulder arthroplasty as well as having the necessary predictive features and outcomes recorded. The machine learning model was able to successfully identify short stay patients, producing an area under the receiver operator curve of 0.77. The multivariate logistic regression identified numerous variables associated with a short stay including, age less than 70 and male sex as well as variables associated with a longer stay including diabetes, COPD, and ASA class greater than 2.
Discussion:
Machine learning may be used to predict which patients are suitable candidates for short stay or outpatient total shoulder arthroplasty based on their medical comorbidities and demographic profile.
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