Zhang Luming, Wang Zichen, Zhou Zhenyu, Li Shaojin, Huang Tao, Yin Haiyan, Lyu Jun
Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province 510630, China.
Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province 510630, China.
iScience. 2022 Aug 12;25(9):104932. doi: 10.1016/j.isci.2022.104932. eCollection 2022 Sep 16.
Sepsis-associated acute kidney injury (S-AKI) is very common and early prediction is beneficial. This study aiming to develop an accurate ensemble model to predict the risk of S-AKI based on easily available clinical information. Patients with sepsis from the United States (US) database Medical Information Mart for Intensive Care-IV were used as a modeling cohort to predict the occurrence of AKI by combining Support Vector Machine, Random Forest, Neural Network, and Extreme Gradient Boost as four first-level learners via stacking algorithm. The external validation databases were the eICU Collaborative Research Database from US and Critical Care Database comprising infection patients at Zigong Fourth People's Hospital from China, whose AUROC values for the ensemble model 48-12 h before the onset of AKI were 0.774-0.788 and 0.756-0.813, respectively. In this study, an ensemble model for early prediction of S-AKI onset was developed and it demonstrated good performance in multicenter external datasets.
脓毒症相关急性肾损伤(S-AKI)非常常见,早期预测有益。本研究旨在基于易于获取的临床信息开发一种准确的集成模型,以预测S-AKI的风险。来自美国数据库重症监护医学信息集市-IV(Medical Information Mart for Intensive Care-IV)的脓毒症患者被用作建模队列,通过堆叠算法将支持向量机、随机森林、神经网络和极端梯度提升作为四个一级学习器,来预测急性肾损伤的发生。外部验证数据库为来自美国的电子重症监护协作研究数据库(eICU Collaborative Research Database)和包含中国自贡市第四人民医院感染患者的重症监护数据库,集成模型在急性肾损伤发作前48 - 12小时的受试者工作特征曲线下面积(AUROC)值分别为0.774 - 0.788和0.756 - 0.813。在本研究中,开发了一种用于早期预测S-AKI发作的集成模型,该模型在多中心外部数据集中表现出良好的性能。