Pancreatic Center, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China.
Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China.
Postgrad Med. 2022 Sep;134(7):703-710. doi: 10.1080/00325481.2022.2099193. Epub 2022 Jul 12.
Acute pancreatitis (AP) is the most common pancreatic disease. Predicting the severity of AP is critical for making preventive decisions. However, the performance of existing scoring systems in predicting AP severity was not satisfactory. The purpose of this study was to develop predictive models for the severity of AP using machine learning (ML) algorithms and explore the important predictors that affected the prediction results.
The data of 441 patients in the Department of Gastroenterology in our hospital were analyzed retrospectively. The demographic data, blood routine and blood biochemical indexes, and the CTSI score were collected to develop five different ML predictive models to predict the severity of AP. The performance of the models was evaluated by the area under the receiver operating characteristic curve (AUC). The important predictors were determined by ranking the feature importance of the predictive factors.
Compared to other ML models, the extreme gradient boosting model (XGBoost) showed better performance in predicting severe AP, with an AUC of 0.906, an accuracy of 0.902, a sensitivity of 0.700, a specificity of 0.961, and a F1 score of 0.764. Further analysis showed that the CTSI score, ALB, LDH, and NEUT were the important predictors of the severity of AP.
The results showed that the XGBoost algorithm can accurately predict the severity of AP, which can provide an assistance for the clinicians to identify severe AP at an early stage.
急性胰腺炎(AP)是最常见的胰腺疾病。预测 AP 的严重程度对于做出预防决策至关重要。然而,现有的评分系统在预测 AP 严重程度方面的表现并不令人满意。本研究旨在使用机器学习(ML)算法开发预测 AP 严重程度的模型,并探讨影响预测结果的重要预测因素。
回顾性分析我院消化内科 441 例患者的临床资料,收集患者的一般资料、血常规和血生化指标、CTSI 评分,建立 5 种不同的 ML 预测模型,预测 AP 的严重程度。通过受试者工作特征曲线下面积(AUC)评估模型的性能。通过预测因子的特征重要性排序来确定重要的预测因素。
与其他 ML 模型相比,极端梯度提升模型(XGBoost)在预测重度 AP 方面表现出更好的性能,AUC 为 0.906,准确率为 0.902,灵敏度为 0.700,特异性为 0.961,F1 得分为 0.764。进一步分析表明,CTSI 评分、ALB、LDH 和 NEUT 是 AP 严重程度的重要预测因素。
结果表明,XGBoost 算法可以准确预测 AP 的严重程度,为临床医生早期识别重度 AP 提供帮助。