Tang Zhongming, Tang Jifu, Liu Wei, Chen Guoqiang, Feng Chenggang, Zhang Aiping
Department of Thoracic Surgery, Chest Hospital of Guangxi Zhuang Autonomous Region Liuzhou, Guangxi Zhuang Autonomous Region, China.
Am J Transl Res. 2024 Jul 15;16(7):2864-2876. doi: 10.62347/IEQE3348. eCollection 2024.
To explore the application value of a gradient boosting decision tree (GBDT) in predicting postoperative atelectasis in patients with destroyed lungs.
A total of 170 patients with damaged lungs who underwent surgical treatment in Chest Hospital of Guangxi Zhuang Autonomous Region from January 2021 to May 2023 were retrospectively selected. The patients were divided into a training set (n = 119) and a validation set (n = 51). Both GBDT algorithm model and Logistic regression model for predicting postoperative atelectasis in patients were constructed. The receiver operating characteristic (ROC) curve, calibration curve and decision curve were used to evaluate the prediction efficiency of the model.
The GBDT model indicated that the relative importance scores of the four influencing factors were operation time (51.037), intraoperative blood loss (38.657), presence of lung function (9.126) and sputum obstruction (1.180). Multivariate Logistic regression analysis revealed that operation duration and sputum obstruction were significant predictors of postoperative atelectasis among patients with destroyed lungs within the training set ( = 0.048, = 0.002). The ROC curve analysis showed that the area under the curve (AUC) for GBDT and Logistic model in the training set was 0.795 and 0.763, and their AUCs in the validation set were 0.776 and 0.811. The GBDT model's predictions closely matched the ideal curve, showing a higher net benefit than the reference line.
GBDT model is suitable for predicting the incidence of complications in small samples.
探讨梯度提升决策树(GBDT)在预测毁损肺患者术后肺不张中的应用价值。
回顾性选取2021年1月至2023年5月在广西壮族自治区胸科医院接受手术治疗的170例肺损伤患者。将患者分为训练集(n = 119)和验证集(n = 51)。构建用于预测患者术后肺不张的GBDT算法模型和Logistic回归模型。采用受试者操作特征(ROC)曲线、校准曲线和决策曲线评估模型的预测效率。
GBDT模型显示,四个影响因素的相对重要性得分分别为手术时间(51.037)、术中出血量(38.657)、肺功能状况(9.126)和痰液阻塞(1.180)。多因素Logistic回归分析显示,在训练集内,手术时长和痰液阻塞是毁损肺患者术后肺不张的显著预测因素(P = 0.048,P = 0.002)。ROC曲线分析显示,训练集中GBDT模型和Logistic模型的曲线下面积(AUC)分别为0.795和0.763,验证集中它们的AUC分别为0.776和0.811。GBDT模型的预测与理想曲线高度吻合,净效益高于参考线。
GBDT模型适用于小样本并发症发生率的预测。