{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T19:33:18Z","timestamp":1787081598291,"version":"build-2736575974"},"reference-count":25,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T00:00:00Z","timestamp":1659052800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Prediction of blood transfusion after adult spinal deformity (ASD) surgery can identify at-risk patients and potentially reduce its utilization and the complications associated with it. The use of artificial neural networks (ANNs) offers the potential for high predictive capability. A total of 1173 patients who underwent surgery for ASD were identified in the 2017\u20132019 NSQIP databases. The data were split into 70% training and 30% testing cohorts. Eighteen patient and operative variables were used. The outcome variable was receiving RBC transfusion intraoperatively or within 72 h after surgery. The model was assessed by its sensitivity, positive predictive value, F1-score, accuracy (ACC), and area under the curve (AUROC). Average patient age was 56 years and 63% were female. Pelvic fixation was performed in 21.3% of patients and three-column osteotomies in 19.5% of cases. The transfusion rate was 50.0% (586\/1173 patients). The best model showed an overall ACC of 81% and 77% on the training and testing data, respectively. On the testing data, the sensitivity was 80%, the positive predictive value 76%, and the F1-score was 78%. The AUROC was 0.84. ANNs may allow the identification of at-risk patients, potentially decrease the risk of transfusion via strategic planning, and improve resource allocation.<\/jats:p>","DOI":"10.3390\/jcm11154436","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T02:06:42Z","timestamp":1659319602000},"page":"4436","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["An Artificial Neural Network Model for the Prediction of Perioperative Blood Transfusion in Adult Spinal Deformity Surgery"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5536-2514","authenticated-orcid":false,"given":"Rafael","family":"De la Garza Ramos","sequence":"first","affiliation":[{"name":"Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10467, USA"},{"name":"Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10467, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mousa K.","family":"Hamad","sequence":"additional","affiliation":[{"name":"Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10467, USA"},{"name":"Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10467, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Ryvlin","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10467, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7839-0032","authenticated-orcid":false,"given":"Oscar","family":"Krol","sequence":"additional","affiliation":[{"name":"Division of Spinal Surgery, Department of Orthopaedic and Neurological Surgery, NYU School of Medicine, New York, NY 10467, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter G.","family":"Passias","sequence":"additional","affiliation":[{"name":"Division of Spinal Surgery, Department of Orthopaedic and Neurological Surgery, NYU School of Medicine, New York, NY 10467, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5886-546X","authenticated-orcid":false,"given":"Mitchell S.","family":"Fourman","sequence":"additional","affiliation":[{"name":"Spine Surgery Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY 10467, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7490-8108","authenticated-orcid":false,"given":"John H.","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Yanamadala","sequence":"additional","affiliation":[{"name":"Hartford HealthCare, Westport, CT 06880, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaroslav","family":"Gelfand","sequence":"additional","affiliation":[{"name":"Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10467, USA"},{"name":"Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10467, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saikiran","family":"Murthy","sequence":"additional","affiliation":[{"name":"Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10467, USA"},{"name":"Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10467, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Yassari","sequence":"additional","affiliation":[{"name":"Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10467, USA"},{"name":"Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10467, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.jspd.2015.04.005","article-title":"A Comprehensive Review of Complication Rates after Surgery for Adult Deformity: A Reference for Informed Consent","volume":"3","author":"Sciubba","year":"2015","journal-title":"Spine Deform."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1097\/BRS.0000000000002515","article-title":"Predictive Modeling for Blood Transfusion after 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