Acute and Critical Care

Original Article

Surgery
Classification of postoperative fever patients in the intensive care unit following intra-abdominal surgery: a machine learning-based cluster analysis using the Medical Information Mart for Intensive Care (MIMIC)-IV database, developed in the United States: Sang Mok Lee, Hongjin Shim; Acute Crit Care. 2025;40(2):293-303. Published online April 30, 2025; DOI: https://doi.org/10.4266/acc.004464

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Background
Postoperative fever is common. However, it can sometimes indicate severe complications such as sepsis or pneumonia. Intensive care unit (ICU) patients who have undergone abdominal surgery have a higher risk of postoperative fever due the physical severity of this type of surgery. Nevertheless, determining when more aggressive or invasive management of fever is necessary remains a challenge.
Methods
We analyzed the Medical Information Mart for Intensive Care (MIMIC)-IV and MIMIC-IV-Note databases, which are open critical care big databases from a single institute in the United States. From this, we selected ICU patients who developed fever after intra-abdominal surgery and classified these patients into two groups using cluster analysis based on diverse variables from the MIMIC-IV databases. Following this cluster analysis, we assessed differences among the identified groups.
Results
Of 2,858 ICU stays after intra-abdominal surgery, 331 postoperative fever cases were identified. These patients were clustered into two groups. Group A included older patients with a higher mortality rate, while group B consisted of younger patients with a lower mortality rate.
Conclusions
Postoperative ICU patients with a fever could be classified into two distinct groups, a high-risk group and low-risk group. The high-risk patient group was characterized by older age, higher Sequential Organ Failure Assessment (SOFA) score, and more unstable hemodynamic status, indicating the need for aggressive management. Clustering postoperative fever patients by clinical variables can support medical decision-making and targeted treatment to improve patient outcomes.

Citations

Citations to this article as recorded by

Nomogram predictive model for the incidence and risk factors of persistent fever after cardiovascular surgery
Feng Zang, Guangxu Mao, Ziyao Quan, Yongfeng Shao, Sheng Zhao, Liyun Wang, Zhanjie Li, Zhongqiu You, Lu Liu, Wensen Chen
BMC Surgery.2025;[Epub] CrossRef
BODY TEMPERATURE MANAGEMENT IN PERIOPERATIVE AND INTENSIVE CARE: CLINICAL STRATEGIES FOR IMPROVING PATIENT OUTCOMES
Marta Nowocień, Karolina Witek, Joanna Kaźmierczak, Anna Mandecka, Kornela Kotucha-Cyl, Weronika Komala, Natalia Guzik, Joanna Gerlach, Dorota Plechawska
International Journal of Innovative Technologies in Social Science.2025;[Epub] CrossRef

Review Article

Pulmonary
Critical Care after Lung Transplantation: Song Yee Kim, Su Jin Jeong, Jin Gu Lee, Moo Suk Park, Hyo Chae Paik, Sungwon Na, Jeongmin Kim; Acute Crit Care. 2018;33(4):206-215. Published online November 30, 2018; DOI: https://doi.org/10.4266/acc.2018.00360

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Abstract PDF

Since the first successful lung transplantation in 1983, there have been many advances in the field. Nevertheless, the latest data from the International Society for Heart and Lung Transplantation revealed that the risk of death from transplantation is 9%. Various aspects of postoperative management, including mechanical ventilation, could affect intensive care unit stay, hospital stay, and immediate postoperative morbidity and mortality. Complications such as reperfusion injury, graft rejection, infection, and dehiscence of anastomosis increase fatal adverse side effects immediately after surgery. In this article, we review the possible immediate complications after lung transplantation and summarize current knowledge on prevention and treatment.

Citations

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