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基于新型放射组学的机器学习框架预测心血管手术后发生急性肾损伤相关谵妄的风险

A Novel Radiomics-Based Machine Learning Framework for Prediction of Acute Kidney Injury-Related Delirium in Patients Who Underwent Cardiovascular Surgery.

机构信息

Department of Cardiothoracic Surgery, School of Medicine, Southeast University, Nanjing 210009, China.

Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.

出版信息

Comput Math Methods Med. 2022 Mar 18;2022:4242069. doi: 10.1155/2022/4242069. eCollection 2022.

Abstract

Acute kidney injury (AKI) can be caused by multiple etiologies and is characterized by a sudden and severe decrease in kidney function. Understanding the independent risk factors associated with the development of AKI and its early detection can refine the risk management and clinical decision-making of high-risk patients after cardiovascular surgery. A retrospective analysis was performed in a single teaching hospital between December 1, 2019, and December 31, 2020. The diagnostic performance of novel biomarkers was assessed using random forest, support vector machine, and multivariate logistic regression. The nomogram from multivariate analysis of risk factors associated with AKI indicated that only LVEF, red blood cell input, and ICUmvat contribute to AKI differentiation and that the difference is statistically significant ( < 0.05). Seven radiomics biomarkers were found among 65 patients to be highly correlated with AKI-associated delirium. The importance of the variables was determined using the multilayer perceptron model; fivefold cross-validation was applied to determine the most important delirium risk factors in radiomics of the hippocampus. Finally, we established a radiomics-based machine learning framework to predict AKI-induced delirium in patients who underwent cardiovascular surgery.

摘要

急性肾损伤(AKI)可由多种病因引起,其特征是肾功能突然严重下降。了解与 AKI 发展相关的独立危险因素及其早期检测,可以完善心血管手术后高危患者的风险管理和临床决策。本研究于 2019 年 12 月 1 日至 2020 年 12 月 31 日在一家教学医院进行了回顾性分析。采用随机森林、支持向量机和多变量逻辑回归评估新型生物标志物的诊断性能。多变量分析 AKI 相关危险因素的列线图表明,只有 LVEF、红细胞输入和 ICUmvat 有助于 AKI 鉴别,差异具有统计学意义(<0.05)。在 65 名患者中发现了 7 个与 AKI 相关谵妄高度相关的放射组学生物标志物。使用多层感知器模型确定变量的重要性;应用五重交叉验证确定海马放射组学中谵妄的最重要危险因素。最后,我们建立了一个基于放射组学的机器学习框架,以预测接受心血管手术的患者发生 AKI 诱导的谵妄。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9321/8956431/292be884f7e7/CMMM2022-4242069.001.jpg

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