机器学习模型的开发和验证,以预测与米辛和提科普拉宁相关的急性损伤:一项回顾性多中心研究
Pin-Yi Lo1, Fan-Ying Chan2, Yi-En Ku2
1Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
International journal of antimicrobial agents
|October 29, 2025
概括
机器学习模型现在可以预测菌素相关的急性损伤 (VA-AKI) 和提科普拉宁相关的AKI (TA-AKI). 这有助于对使用这些抗生素的患者进行早期风险评估.
科学领域:
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學.
- 数据科学数据科学数据科学
背景情况:
- 范科米辛和提科普拉宁对于格拉姆阳性感染至关重要,但具有毒性风险.
- 毒性可能导致长时间住院,增加发病率,死亡率和医疗保健费用.
研究的目的:
- 开发和验证机器学习模型,用于预测与万科米辛相关的急性损伤 (VA-AKI) 和与泰科普拉宁相关的AKI (TA-AKI).
- 为了能够对接受这些抗生素的患者进行早期风险评估和个性化管理.
主要方法:
- 使用台北医科大学临床研究数据库 (2010年2月 - 2020年12月) 进行的回顾性研究.
- 通过使用特征重要性 (RFECV) 和SHapley添加式扩展重要性 (ShapRFECV) 的递归特征消除来选择特征.
- 使用AUROC等指标构建和评估XGBoost和LightGBM模型,并使用SHAP分析进行解释.
主要成果:
- 使用ShapRFECV选择的特性,XGBoost模型实现了最佳的预测性能.
- 内部验证显示AUROC为0.798 (95%CI:0.791-0.804). 这是一个很好的结果.
- 外部验证显示AUROC为0.779 (95%CI:0.767-0.791). 这是一个很好的结果.
结论:
- 开发的XGBoost模型准确地预测了凡科米辛和提科普拉宁使用者的AKI.
- 这支持早期风险分层和个性化患者护理.
- 建议进一步进行多中心前性验证,以提高现实世界的适用性.
相关概念视频
Acute Kidney Injury IV: Diagnostic Studies and Prevention
256
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
256
Acute Kidney Injury I: Introduction
562
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
562
Acute Kidney Injury II: Pathophysiology
870
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
870
Acute Kidney Injury V: Interprofessional Care
294
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
294
Acute Kidney Injury III: Clinical Manifestations
804
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
804
Acute Kidney Injury VI: Nursing Management
377
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
377


