Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Determination of Preanesthetic High-Risk Using Fuzzy Risk Evaluation for Surgical Operations
Cerrahi Ameliyatlardaki Preanestezik Yüksek Riskin Bulanık Risk Değerlendirmesi İle Belirlenmesi
Barış SANDALa, Yüksel HACIOĞLUa, Nurkan YAĞIZa, Ece SALİHOĞLUb
aDepartment of Mechanical Engineering, İstanbul University-Cerrahpaşa Faculty of Engineering,
bDepartment of Pediatric Cardiovascular Surgery, İstanbul Bilim University, Avrupa Florence Nightingale Hospital Research and Application Center, İstanbul, TURKEY
Turkiye Klinikleri J Med Sci. 2019;39(1):19-25
doi: 10.5336/medsci.2018-62178
Article Language: EN
Full Text
ABSTRACT
 Objective: Determination of preanesthetic high risk during surgical procedures using fuzzy risk evaluation. Material and Methods: In this study for the high risk patient classification, five major criteria comprising cardiac, pulmonary, renal or liver diseases and diabetes mellitus and three minor criteria comprising patients' age, body mass index and cigarette smoking were chosen to define the high-risk group. Since the fuzzy logic gives the ability to use linguistic expressions, that include the intuition of human operators or experts during the decision making process, it this study by using fuzzy logic modelling, rules for high risks were developed. To reach this aim a new fuzzy logic decision system is proposed that uses four input variables to calculate the risk as a percentage that is the output of the fuzzy system. Results: Using Fuzzy risk evaluation; By taking into account the number of inputs and number of their corresponding membership functions, it is deduced that 270 fuzzy rules will be enough. Conclusion: In this study, a risk classification model was developed by combining the risk criteria defined by previous medical studies and clinical experience with a fuzzy logic model in the preoperative period. This developed fuzzy logic model needs to be investigated by selecting specific groups of patients and specific operations.

Keywords: Anesthesia; high risk; pre anesthetic evaluation; fuzzy logic risk evaluation
ÖZET
 Amaç: Bu çalışmada bulanık mantık risk değerlendirmesi ile cerrahi girişim sırasında preanestezik yüksek riskin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışmada yüksek risk kriterli hastaların sınıflandırılmasında: Kalp, akciğer, böbrek, karaciğer hastaları ve diyabetus mellitus olan hastalar major risk kriterli olarak, hastanın yaşı, beden kitle indeksi ve sigara kullanımı ise hastalar için minör risk kriteri olarak belirlenmiştir. Bir minör ve bir major kriteri olan hastalar yüksek riskli olarak adlandırılmıştır. Ardından, bulanık mantık modelleme yöntemi kullanarak, yüksek riskler için kurallar geliştirilmiştir. Bulanık mantık, karar verme sürecinde operatör veya uzman insanların sezgilerini içeren dilsel ifadelerin kullanımına imkan verdiği için, bu çalışmada yüksek risk hesabı yapmak için bulanık mantık kullanılarak risk hesabında uygulanacak kurallar belirlenmiştir. Bu amaca ulaşabilmek maksadıyla çıkış olarak yüzdelik risk değerini hesaplamak için dört adet giriş değişkeni kullanan yeni bir bulanık mantıklı karar verme sistemi önerilmiştir. Bulgular: Bulanık mantık risk analizi ile belirlenen girişler ve bunlara karşılık gelen üyelik fonksiyonlarının sayısı dikkate alınarak, 270 adet bulanık mantık kuralı belirlenmiştir. Sonuç: Bu çalışma ile ameliyat öncesi dönemde önceki tıbbi çalışmalar ve klinik tecrübeler ile belirlenmiş risk kriterlerini bir bulanık mantık karar verme modeli ile birleştirerek bir risk sınıflandırması modeli geliştirilmiştir. Bu geliştirilen bulanık mantık modelinin belirli hasta grupları ve belirli ameliyatlar seçilerek araştırılmasına ihtiyaç vardır.

Anahtar Kelimeler: Anestezi; yüksek risk; preanestezik değerlendirme; bulanık mantık risk değerlendirmesi
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