非糖尿病患者の心臓手術における術後高血糖予測のための複数の機械学習手法の比較
Jinyan Wu1, Mengli Zhang2, Senxiu Cui1
1School of Nursing, Bengbu Medical University, Bengbu, Anhui, China.
Background:
Stress-induced hyperglycemia (SHG) represents a significant metabolic complication in non-diabetic cardiac surgery older adult patients, with substantial implications for postoperative outcomes. Despite its clinical importance, reliable predictive tools remain scarce. This study systematically compared the performance of logistic regression 5 s. advanced machine learning algorithms for SHG risk prediction in this vulnerable population.
Patients And Methods:
We conducted a retrospective cohort analysis of 600 patients (≥65 years) undergoing cardiac surgery at a tertiary medical center (January 2021-May 2025). Six clinically relevant perioperative variables were incorporated into five predictive models: logistic regression, Random Forest (RF), Gradient Boosting Machine (GBM), Adaptive Boosting (AdaBoost), and Extreme Gradient Boosting (XGBoost). Model performance was rigorously evaluated using AUC-ROC with 95% confidence intervals, sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and precision.
Results:
The incidence of SHG in this cohort was 70.5%. Comparative analysis revealed logistic regression as the top-performing model (AUC 0.944, 95% CI 0.923-0.966), surpassing other algorithms: GBM (0.923, 0.902-0.952), 10GBoost (0.904, 0.890-0.941), AdaBoost (0.916, 0.871-0.936), and RF (0.877, 0.866-0.932). Moreover, the logistic model achieved optimal performance in sensitivity (94.5%), specificity (93.4%), PPV (97.7%), and NPV (96.8%).
Conclusion:
In contrast to more complex machine learning approaches, logistic regression demonstrated superior predictive accuracy for SHG in non-diabetic cardiac surgery older adult patients. Its exceptional performance metrics and clinical interpretability support its practical utility as an effective decision-support tool for perioperative risk stratification and management.
