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一种用于预测入住重症监护病房的急性肾损伤患者死亡率的决策支持系统。

A decision support system for the prediction of mortality in patients with acute kidney injury admitted in intensive care unit.

作者信息

Kayaalti Selda, Kayaalti Omer, Hakan Aksebzeci Bekir

机构信息

Develi Hatice-Muammer Kocaturk Public Hospital, Department of Anesthesiology and Reanimation, Develi, Kayseri, Turkey.

Kayseri University, Develi Huseyin Sahin Vocational College, Department of Computer Technologies, Kayseri, Turkey.

出版信息

J Appl Biomed. 2020 Mar;18(1):26-32. doi: 10.32725/jab.2020.004. Epub 2020 Feb 28.

Abstract

Intensive care unit (ICU) is a very special unit of a hospital, where healthcare professionals provide treatment and, later, close follow-up to the patients. It is crucial to estimate mortality in ICU patients from many viewpoints. The purpose of this study is to classify the status of patients with acute kidney injury (AKI) in ICU as early mortality, late mortality, and survival by the application of Classification and Regression Trees (CART) algorithm to the patients' attributes such as blood urea nitrogen, creatinine, serum and urine neutrophil gelatinase-associated lipocalin (NGAL), alkaline phosphatase, lactate dehydrogenase (LDH), gamma-glutamyl transferase, laboratory electrolytes, blood gas, mean arterial pressure, central venous pressure and demographic details of patients. This study was conducted 50 patients with AKI who were followed up in the ICU. The study also aims to determine the significance of relationship between the attributes used in the prediction of mortality in CART and patients' status by employing the Kruskal-Wallis H test. The classification accuracy, sensitivity, and specificity of CART for the tested attributes for the prediction of early mortality, late mortality, and survival of patients were 90.00%, 83.33%, and 91.67%, respectively. The values of both urine NGAL and LDH on day 7 showed a considerable difference according to the patients' status after being examined by the Kruskal-Wallis H test.

摘要

重症监护病房(ICU)是医院中一个非常特殊的科室,医护人员在那里为患者提供治疗,并在之后进行密切随访。从多个角度评估ICU患者的死亡率至关重要。本研究的目的是通过将分类与回归树(CART)算法应用于患者的属性,如血尿素氮、肌酐、血清和尿液中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、碱性磷酸酶、乳酸脱氢酶(LDH)、γ-谷氨酰转移酶、实验室电解质、血气、平均动脉压、中心静脉压以及患者的人口统计学细节,将ICU中急性肾损伤(AKI)患者的状态分类为早期死亡、晚期死亡和存活。本研究对50例在ICU接受随访的AKI患者进行。该研究还旨在通过采用Kruskal-Wallis H检验来确定CART中用于预测死亡率的属性与患者状态之间关系的显著性。CART对测试属性预测患者早期死亡、晚期死亡和存活的分类准确率、敏感性和特异性分别为90.00%、83.33%和91.67%。经Kruskal-Wallis H检验,第7天尿液NGAL和LDH的值根据患者状态显示出相当大的差异。

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