Evidence map›Paper›PMID 40886713›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2025

Prediction of postoperative infections by strategic data imputation and explainable machine learning.

Hugo Guillen-Ramirez, Daniel Sanchez-Taltavull, Stéphanie Perrodin, Sarah Peisl, Karen Triep, Christophe Gaudet-Blavignac, Olga Endrich, Guido Beldi

Abstract read
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Hugo Guillen-RamirezDepartment of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland.ORCID 0000-0003-0705-7432
Daniel Sanchez-TaltavullDepartment of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland.ORCID 0000-0002-4944-0360
Stéphanie PerrodinDepartment of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland.ORCID 0000-0002-2767-3219
Sarah PeislDepartment of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland.ORCID 0000-0002-1215-6964
Karen TriepMedical Directorate, Medizincontrolling, Inselspital, University Hospital Bern, Insel Gruppe, Bern 3010, Switzerland.ORCID 0000-0002-2345-3155
Christophe Gaudet-BlavignacDepartment of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva 1211, Switzerland.ORCID 0000-0001-6527-5898
Olga EndrichMedical Directorate, Medizincontrolling, Inselspital, University Hospital Bern, Insel Gruppe, Bern 3010, Switzerland.ORCID 0000-0003-0839-9821
Guido BeldiDepartment of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland.ORCID 0000-0002-9914-3807

Funding

Multidisciplinary Center for Infectious DiseasesSwiss Personalized Health Network SPHN DEM-2022-08
6 · The paper itself

Abstract

objectivesInfections following healthcare-associated interventions drive patient morbidity and mortality, making early detection essential. Traditional predictive models utilize preoperative surgical characteristics. This study evaluated whether integrating postoperative laboratory values and their kinetics could improve outcome prediction. MATERIALS AND

methods91 794 surgical cases were extracted from electronic health records (EHR) and analyzed to predict bacterial infection as the endpoint. The endpoint was documented in the EHR as ICD-10 by a professional coding team. Variables were grouped as preoperative, intraoperative, or postoperative. Strategic imputation was used for postoperative missing laboratory values. Procedure-agnostic prediction models were built incorporating both static and kinetic properties of laboratory values.

resultsThe integration of kinetics of laboratory values into a machine learning predictor achieved a recall, precision and ROC AUC at postoperative day 2 of 0.71, 0.69, and 0.83, respectively. Moreover, infection detection outperformed clinician-based decision-making, as reflected by the postoperative timing of antibiotic administration. The analysis identified previously unknown, informative combinations of routine markers from hepatic, renal, and bone marrow functions that predict outcome. DISCUSSION: Dynamic modelling of postoperative laboratory values enhanced the timeliness and accuracy of infection detection compared with static or preoperative-only models. The integration of explainable machine learning supports clinical interpretation and highlights the contribution of multiple organ systems to postoperative infection risk.

conclusionA surgery-independent workflow integrating time-series values from laboratory parameters to enhance baseline predictors of infection. This interpretable approach is generalizable across procedures and has the potential to optimize patient outcomes and resource use in surgical care.

Indexed as

Bacterial InfectionsMachine LearningPostoperative ComplicationsSurgical Wound InfectionElectronic Health RecordsFemaleHumansMaleMiddle AgedROC Curveinfectionlaboratory valuesmachine learningsurgery

Identifiers

PMID40886713
PMCPMC12626223

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.