Acute Colonic Pseudoobstruction

Chudzinski, Allen; Thompson, Earl V.; Ayscue, Jennifer M.

doi:10.1055/s-0035-1549100

Cited by 54 publications

(43 citation statements)

References 30 publications

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“…For that reason, it becomes important to identify patients that may be at risk of dying during their ICU stay. Out dataset revealed that the majority of admitted patients are elderly individuals with a median age of 63 years [34][35][36]. In this cohort of patients, we observed labs which were performed in the first 24 hours to predict overall survival.…”

Section: Discussionmentioning

confidence: 99%

A Hybrid Machine Learning Framework to Predict Early Risk of Mortality in Paralytic Ileus Patients using Electronic Health Records

Ahmad

Ali

Raza-Ul-Mustafa

et al. 2019

Preprint

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Background and Objective: Paralytic Ileus (PI) is the pseudo-obstruction of the intestine secondary to intestinal muscle paralysis. PI is caused by several reasons such as overuse of medications, spinal injuries, inflammation, abdominal surgery, etc. We have developed an early mortality prediction framework that can help intensivist, surgeons and other medical professionals to optimize clinical management for PI patients in terms of optimal treatment strategy and resource planning. Methods:We used publicly available ICU database called MIMIC III v1.4, extracted patients that had paralytic ileus as primary diagnosis over the age of 18 years old. We developed FLAIM Framework a two-phase model (Phase I: Statistical testing and Phase II: Machine Learning application) that was compare to traditional methods of machine learning. We used five different machine learning algorithms to test the validity of our Framework. We evaluated the effectiveness of the proposed framework by comparing accuracy, sensitivity, specificity, Receiver Operating Characteristic (ROC) curves, and area under the curve (AUC) for each model. Results:The highest improvement in AUC of 7.78% was observed due to application of the proposed FLAIM method. Additionally, almost for all the machine learning models, improvement in accuracy was also observed. With the FLAIM framework, we recorded an accuracy of 81.30% and AUC of 81.38% under support vector machine (with RBF kernel) model in predicting mortality during a hospital stay for the PI patients Discussion: Our results show promising clinical outcome prediction and application for individual patients admitted to the ICU with paralytic ileus after the first 24 hours of admission.

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Section: Discussionmentioning

confidence: 99%

A Hybrid Machine Learning Framework to Predict Early Risk of Mortality in Paralytic Ileus Patients using Electronic Health Records

Ahmad

Ali

Raza-Ul-Mustafa

et al. 2019

Preprint

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“…Significant abdominal distention with tympany is invariably seen on physical examination. Auscultation often reveals high-pitched but sometimes tinkling bowel sounds (Chudzinski et al 2015). However, bowel sounds may be absent in 10% of cases (Vanek and Al-Salti 1986).…”

Section: Clinical Manifestations and Diagnosismentioning

confidence: 99%

Acute Colonic Pseudo-Obstruction

Widjaja¹,

Dharmarajan

2019

Geriatric Gastroenterology

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Acute colonic pseudo-obstruction is a pathologic dilatation of the colon without the presence of mechanical obstruction or inflammatory process in the colonic wall. The pathogenic factors for this disorder include autonomic imbalance, degeneration of enteric ganglion cells, elevated nitric oxide, activation of colo-colonic inhibitory reflex, and disruption of enteric nervous system and its neurotransmitters by various chronic diseases, medications, and infections. Acute colonic pseudo-obstruction usually occurs in older adults who have multimorbidity or use medications affecting the bowel motility. Abdominal distention and pain are the main features of this condition. X-ray or computed tomography scan of the abdomen help in establishing the diagnosis. Timely recognition and close monitoring are important in management. Nonoperative management, including neostigmine injection and colonoscopic decompression, should be started immediately in uncomplicated cases. Surgical intervention is mainly indicated in the presence of ischemia, perforation, or refractoriness to nonoperative measures.

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“…The decision must be made on a case by case basis. The only objective elements that guide the gastroenterologist are the diameter of the cecum (greater than 12 cm) and the duration of the pseudo-obstruction (more than 6 days) 11 .…”

Section: ) Exsufflation Of the Colonmentioning

confidence: 99%