Postoperative Nausea and Vomiting Prediction: Machine Learning Insights from a Comprehensive Analysis of Perioperative Data

Postoperative nausea and vomiting (PONV) are common complications after surgery. This study aimed to present the utilization of machine learning for predicting PONV and provide insights based on a large amount of data. This retrospective study included data on perioperative features of patients, such as patient characteristics and perioperative factors, from two hospitals. Logistic regression algorithms, random forest, light-gradient boosting machines, and multilayer perceptrons were used as machine learning algorithms to develop the models. The dataset of this study included 106,860 adult patients, with an overall incidence rate of 14.4% for PONV. The area under the receiver operating characteristic curve (AUROC) of the models was 0.60-0.67. In the prediction models that included only the known risk and mitigating factors of PONV, the AUROC of the models was 0.54-0.69. Some features were found to be associated with patient-controlled analgesia, with opioids being the most important feature in almost all models. In conclusion, machine learning provides valuable insights into PONV prediction, the selection of significant features for prediction, and feature engineering.