Department of Gastroenterology, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
Department of Gastroenterology, People's Hospital of Chongqing Hechuan, Chongqing, China.
J Dig Dis. 2019 Sep;20(9):486-494. doi: 10.1111/1751-2980.12796. Epub 2019 Jul 21.
The aim of this study was to evaluate the efficacy of artificial neural networks (ANN) in predicting intra-abdominal infection in moderately severe (MASP) and severe acute pancreatitis (SAP) compared with that of a logistic regression model (LRM).
Patients suffering from MSAP or SAP from July 2014 to June 2017 in three affiliated hospitals of the Army Medical University in Chongqing, China, were enrolled in this study. A univariate analysis was used to determine the different parameters between patients with and without intra-abdominal infection. Subsequently, these parameters were used to build LRM and ANN.
Altogether 263 patients with MSAP or SAP were enrolled in this retrospective study. A total of 16 parameters that differed between patients with and without intra-abdominal infection were used to construct both models. The sensitivity of ANN and LRM was 80.99% (95% confidence interval [CI] 72.63-87.33) and 70.25% (95% CI 61.15-78.04), respectively (P > 0.05), whereas the specificity was 89.44% (95% CI 82.89-93.77) and 77.46% (95% CI 69.54-83.87), respectively (P < 0.05). ANN predicted the risk of intra-abdominal infection better than LRM (area under the receiver operating characteristic curve: 0.923 [0.883-0.952] vs 0.802 [0.749-0.849], P < 0.001).
ANN accurately predicted intra-abdominal infection in MSAP and SAP and is an ideal tool for predicting intra-abdominal infection in such patients. Coagulation parameters played an important role in such prediction.
本研究旨在评估人工神经网络(ANN)在预测中重度急性胰腺炎(MSAP)和重症急性胰腺炎(SAP)患者腹腔内感染方面的疗效,并与逻辑回归模型(LRM)进行比较。
回顾性分析 2014 年 7 月至 2017 年 6 月重庆陆军军医大学三所附属医院收治的 MSAP 或 SAP 患者,采用单因素分析比较腹腔内感染患者与无腹腔内感染患者的不同参数,然后使用这些参数构建 LRM 和 ANN。
共纳入 263 例 MSAP 或 SAP 患者。共有 16 个参数在腹腔内感染患者与无腹腔内感染患者之间存在差异,用于构建两种模型。ANN 和 LRM 的灵敏度分别为 80.99%(95%置信区间[CI] 72.63%-87.33%)和 70.25%(95% CI 61.15%-78.04%)(P>0.05),而特异性分别为 89.44%(95% CI 82.89%-93.77%)和 77.46%(95% CI 69.54%-83.87%)(P<0.05)。ANN 预测腹腔内感染的风险优于 LRM(受试者工作特征曲线下面积:0.923[0.883-0.952] vs 0.802[0.749-0.849],P<0.001)。
ANN 能准确预测 MSAP 和 SAP 患者的腹腔内感染,是预测此类患者腹腔内感染的理想工具。凝血参数在预测中起着重要作用。