• Rémi Florquin, Renaud Florquin, Denis Schmartz, Philippe Dony, and Giovanni Briganti.
• Department of Anesthesiology, CHU Charleroi, Chaussée de Bruxelles 140, 6042, Lodelinsart, Belgium. remi.florquin@gmail.com.
• J Anesth. 2024 Dec 1; 38 (6): 747755747-755.

PurposeManaging children undergoing cardiac surgery with cardiopulmonary bypass (CPB) presents a significant challenge for anesthesiologists. Machine Learning (ML)-assisted tools have the potential to enhance the recognition of patients at risk of complications and predict potential issues, ultimately improving outcomes.MethodsWe evaluated the prediction capacity of six models, ranging from logistic regression to support vector machine, using a dataset comprising 33 variables and 1364 subjects. The Area Under the Curve (AUC) and the F1 score served as the primary evaluation metrics. Our primary objectives were twofold: first, to develop an effective prediction model, and second, to create a user-friendly comprehensive model for identifying high-risk patients.ResultsThe logistic regression model demonstrated the highest effectiveness, achieving an AUC of 83.65%, and an F1 score of 0.7296, with balanced sensitivity and specificity of 77.94% and 76.47%, respectively. In comparison, the comprehensive three-layer decision tree model achieved an AUC of 72.84%, with sensitivity (79.41%) comparable to more complex models.ConclusionOur machine learning-assisted tools provide an additional perspective and enhance the predictive capabilities of traditional scoring methods. These tools can assist anesthesiologists in making well-informed decisions. Furthermore, we have successfully demonstrated the feasibility of creating a practical white-box model. The next steps involve conducting clinical validation and multicenter cross-validation.Trial RegistrationNCT05537168.© 2024. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.

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