Development of a predictive model for hypoxia due to sedatives in gastrointestinal endoscopy: a prospective clinical study in Korea
| Title: | Development of a predictive model for hypoxia due to sedatives in gastrointestinal endoscopy: a prospective clinical study in Korea |
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| Authors: | Jung Wan Choe, Jong Jin Hyun, Seong-Jin Son, Seung-Hak Lee |
| Source: | Clinical Endoscopy, Vol 57, Iss 4, Pp 476-485 (2024) |
| Publisher Information: | Korean Society of Gastrointestinal Endoscopy, 2024. |
| Publication Year: | 2024 |
| Collection: | LCC:Internal medicine LCC:Diseases of the digestive system. Gastroenterology |
| Subject Terms: | drug-related side effects and adverse reactions, endoscopy, hypnotics and sedatives, hypoxia, risk factors, Internal medicine, RC31-1245, Diseases of the digestive system. Gastroenterology, RC799-869 |
| More Details: | Background/Aims Sedation has become a standard practice for patients undergoing gastrointestinal (GI) endoscopy. However, considering the serious cardiopulmonary adverse events associated with sedatives, it is important to identify patients at high risk. Machine learning can generate reasonable prediction for a wide range of medical conditions. This study aimed to evaluate the risk factors associated with sedation during GI endoscopy and develop a predictive model for hypoxia during endoscopy under sedation. Methods This prospective observational study enrolled 446 patients who underwent sedative endoscopy at the Korea University Ansan Hospital. Clinical data were used as predictor variables to construct predictive models using the random forest method that is a machine learning algorithm. Results Seventy-two of the 446 patients (16.1%) experienced life-threatening hypoxia requiring immediate medical intervention. Patients who developed hypoxia had higher body weight, body mass index (BMI), neck circumference, and Mallampati scores. Propofol alone and higher initial and total dose of propofol were significantly associated with hypoxia during sedative endoscopy. Among these variables, high BMI, neck circumference, and Mallampati score were independent risk factors for hypoxia. The area under the receiver operating characteristic curve for the random forest-based predictive model for hypoxia during sedative endoscopy was 0.82 (95% confidence interval, 0.79–0.86) and displayed a moderate discriminatory power. Conclusions High BMI, neck circumference, and Mallampati score were independently associated with hypoxia during sedative endoscopy. We constructed a model with acceptable performance for predicting hypoxia during sedative endoscopy. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2234-2400 2234-2443 |
| Relation: | http://www.e-ce.org/upload/pdf/ce-2023-198.pdf; https://doaj.org/toc/2234-2400; https://doaj.org/toc/2234-2443 |
| DOI: | 10.5946/ce.2023.198 |
| Access URL: | https://doaj.org/article/93d82222d62246d4bb64667abb67f597 |
| Accession Number: | edsdoj.93d82222d62246d4bb64667abb67f597 |
| Database: | Directory of Open Access Journals |
| ISSN: | 22342400 22342443 |
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| DOI: | 10.5946/ce.2023.198 |
| Published in: | Clinical Endoscopy |
| Language: | English |