Gesang Luobu, Suona Yangzong, Danzeng Zhuoga, Ci Bai, Gesang Quzhen, Cidan WangJiu, Dingzeng Qiangba, Baima Zhuoga, Zhaxi Quzhen
High Altitude Medical Research Institute of Tibet Autonomous Region, 18 Linkuo North Road, Lhasa, 850000, China.
Key Laboratory of Transitional Medicine for Human Adaptation to the High-Altitude of Tibet Autonomous Region, Tibet Autonomous Region People's Hospital, Lhasa, 850000, China.
BMC Med Inform Decis Mak. 2025 Apr 18;25(1):171. doi: 10.1186/s12911-025-02992-y.
This study aimed to identify key predictors for the severity of High Altitude Pulmonary Edema (HAPE) to assist clinicians in promptly recognizing severely affected patients in the emergency department, thereby reducing associated mortality rates. Multinomail logistic regression, random forest, and decision tree methods were utilized to determine important predictor variables and evaluate model performance. A total of 508 patients diagnosed with HAPE were included in the study, with 53 variables analyzed. Lung rales, sputum sputuming, heart rate, and oxygen saturation were identified as the most relevant predictors for the LASSO model. Subsequently, Multinomail logistic regression, decision tree, and random forest models were trained and evaluated using these factors on a test set. The random forest model showed the highest performance, with an accuracy of 77.94%, precision of 70.27%, recall of 68.22%, and F1 score of 68.96%, outperforming the other models. Further analysis revealed significant differences in predictive capabilities among the models for HAPE patients at varying severity levels. The random forest model demonstrated high predictive accuracy across all severity levels of HAPE, particularly excelling in identifying severely ill patients with an impressive AUC of 0.86. The study assessed the reliability and effectiveness of the HAPE severity scoring model by validating Multinomail logistic regression and random forest models. This study introduces a valuable screening tool for categorizing the severity of HAPE, aiding healthcare providers in recognizing individuals with severe HAPE, enabling prompt treatment and the formulation of suitable therapeutic approaches.
本研究旨在确定高原肺水肿(HAPE)严重程度的关键预测因素,以帮助临床医生在急诊科迅速识别重症患者,从而降低相关死亡率。采用多项逻辑回归、随机森林和决策树方法来确定重要的预测变量并评估模型性能。共有508例诊断为HAPE的患者纳入研究,分析了53个变量。肺部啰音、咳痰、心率和血氧饱和度被确定为LASSO模型最相关的预测因素。随后,在测试集上使用这些因素对多项逻辑回归、决策树和随机森林模型进行训练和评估。随机森林模型表现最佳,准确率为77.94%,精确率为70.27%,召回率为68.22%,F1分数为68.96%,优于其他模型。进一步分析显示,不同严重程度的HAPE患者模型的预测能力存在显著差异。随机森林模型在HAPE的所有严重程度水平上均表现出较高的预测准确性,尤其在识别重症患者方面表现出色,AUC高达0.86。本研究通过验证多项逻辑回归和随机森林模型评估了HAPE严重程度评分模型的可靠性和有效性。本研究引入了一种有价值的筛查工具,用于对HAPE的严重程度进行分类,帮助医疗保健提供者识别重症HAPE患者,以便及时治疗并制定合适的治疗方法。