预测慢性阻塞性肺病患者急性病风险和不良结果:可解释的机器学习方法
Siqi Jiang1, Lingyu Xu1, Xinyuan Wang1
1Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Renal failure
|April 8, 2025
概括
机器学习模型预测急性损伤 (AKI),急性病 (AKD) 和慢性阻塞性肺病 (COPD) 患者的死亡率. 功能轨迹是预测死亡率的关键,有助于临床决策和改善患者的治疗结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 肺部病理学 肺部病理学
- 数据科学数据科学数据科学
背景情况:
- 在慢性阻塞性肺病 (COPD) 患者中,急性损伤 (AKI) 和急性病 (AKD) 的了解很少.
- 与急性/次急性损伤相关的COPD死亡率需要进一步调查.
研究的目的:
- 开发机器学习模型来预测COPD患者的AKI,AKD和死亡率.
- 在Web应用程序中使用预测模型来支持临床决策.
主要方法:
- 包括从2016年1月到2018年12月的2829名住院患者.
- 训练并测试了八个机器学习算法,用AUROC和SHAP评估性能.
- 开发基于表现最佳的模型的Web应用程序.
主要成果:
- 发病率:AKI为13.71%,AKD为15.11%,死亡率为4.84%.
- 轻GBM模型实现了0.815 (AKI),0.827 (AKD) 和0.934 (死亡率) 的AUROC.
- 确定了关键预测因素:Scr,中性粒细胞百分比,cystatin c,BUN,LDH,年龄,AKI等级,HDL-C,多巴胺/上腺素使用,以及功能轨迹.
结论:
- AKI和AKD在COPD患者中具有显著的发病率.
- 功能轨迹是这一群体死亡率的关键预测指标.
- 开发的网络应用程序可以识别高风险患者,潜在地减少不良事件和疾病进展.
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