Risk Factors Identification of Sepsis and Septic Shock After Major Abdominal Surgery Based on Artificial Intelligence

Xinhua Hospital, Shanghai Jiao Tong University School of Medicine22,646 enrolled

Overview

The goal of this observational study is to identify the risk factors and build the early warning system of sepsis and septic shock after major abdominal surgery based on artificial intelligence. The main questions it aims to answer are: What are the high risk factors of postoperative sepsis? Which factors can accelerate the progression of sepsis? Researchers will collect perioperative characteristics to construct predictive models of postoperative sepsis in a retrospective abdominal surgical population based on artificial intelligence, and the accuracy of the models were tested in an external dataset.

Study Type

OBSERVATIONAL

Enrollment

22,646

Conditions

Sepsis Postoperative Complications

Interventions

Exposure to major abdominal surgeryPROCEDURE

This study is a retrospective cohort study. The 'exposure' situation is based on historical records and observation, and no active intervention has been conducted on the study subjects to change their exposure status.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria： 1. Patients undergoing major abdominal surgery. 2. The surgeon performing the operation has extensive experience in specialized surgeries such as upper gastrointestinal, hepatobiliary and pancreatic, colorectal, gynecological, and urological surgeries, having completed at least 50 corresponding specialized surgical cases. 3. The anesthesiologist performing the operation has more than 5 years of clinical experience. 4. All surgical patients receive general anesthesia. 5. Patients are aged ≥ 18 years. Exclusion Criteria： 1\. Pregnancy-related surgeries (cesarean section, abortion surgery). 2. Patients with known preoperative infection or suspected infection. 3. Severely malnourished patients (BMI reference values are 17 kg/m² for patients \< 70 years old and 17.8 kg/m² for patients \> 70 years old). 4\. Patients who have previously undergone abdominal surgery. 5. Patients without sufficient data, including demographic variables (such as age, gender), surgical details (surgery duration, surgical grade, anesthesia grade, anesthesia duration), and hospitalization details (such as ICU stay, in-hospital mortality).

Outcomes

Primary Outcomes

Sepsis within 28 days after surgery.

For patients within 28 days after surgery, if there is a recorded or suspected infection and the Sequential Organ Failure Assessment (SOFA) score is ≥ 2 points, sepsis can be diagnosed. For sepsis patients, if they still have persistent hypotension after adequate volume resuscitation and require vasopressor drugs to maintain a Mean Atrial Pressure (MAP) ≥ 65 mmHg and a serum lactate level \> 2 mmol/L, it is considered that the sepsis patient has progressed to septic shock.

Time frame: In the 28-day period following surgery