Cargando…

A Machine Learning-Based Prediction Model for Acute Kidney Injury in Patients With Congestive Heart Failure

BACKGROUND: Machine learning (ML) has been used to build high performance prediction model. Patients with congestive heart failure (CHF) are vulnerable to acute kidney injury (AKI) which makes treatment difficult. We aimed to establish an ML-based prediction model for the early identification of AKI...

Descripción completa

Detalles Bibliográficos
Autores principales: Peng, Xi, Li, Le, Wang, Xinyu, Zhang, Huiping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8931220/
https://www.ncbi.nlm.nih.gov/pubmed/35310995
http://dx.doi.org/10.3389/fcvm.2022.842873
_version_ 1784671209317728256
author Peng, Xi
Li, Le
Wang, Xinyu
Zhang, Huiping
author_facet Peng, Xi
Li, Le
Wang, Xinyu
Zhang, Huiping
author_sort Peng, Xi
collection PubMed
description BACKGROUND: Machine learning (ML) has been used to build high performance prediction model. Patients with congestive heart failure (CHF) are vulnerable to acute kidney injury (AKI) which makes treatment difficult. We aimed to establish an ML-based prediction model for the early identification of AKI in patients with CHF. METHODS: Patients data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database, and patients with CHF were selected. Comparisons between several common ML classifiers were conducted to select the best prediction model. Recursive feature elimination (RFE) was used to select important prediction features. The model was improved using hyperparameters optimization (HPO). The final model was validated using an external validation set from the eICU Collaborative Research Database. The area under the receiver operating characteristic curve (AUROC), accuracy, calibration curve and decision curve analysis were used to evaluate prediction performance. Additionally, the final model was used to predict renal replacement therapy (RRT) requirement and to assess the short-term prognosis of patients with CHF. Finally, a software program was developed based on the selected features, which could intuitively report the probability of AKI. RESULTS: A total of 8,580 patients with CHF were included, among whom 2,364 were diagnosed with AKI. The LightGBM model showed the best prediction performance (AUROC = 0.803) among the 13 ML-based models. After RFE and HPO, the final model was established with 18 features including serum creatinine (SCr), blood urea nitrogen (BUN) and urine output (UO). The prediction performance of LightGBM was better than that of measuring SCr, UO or SCr combined with UO (AUROCs: 0.809, 0.703, 0.560 and 0.714, respectively). Additionally, the final model could accurately predict RRT requirement in patients with (AUROC = 0.954). Moreover, the participants were divided into high- and low-risk groups for AKI, and the 90-day mortality in the high-risk group was significantly higher than that in the low-risk group (log-rank p < 0.001). Finally, external validation using the eICU database comprising 9,749 patients with CHF revealed satisfactory prediction outcomes (AUROC = 0.816). CONCLUSION: A prediction model for AKI in patients with CHF was established based on LightGBM, and the prediction performance of this model was better than that of other models. This model may help in predicting RRT requirement and in identifying the population with poor prognosis among patients with CHF.
format Online
Article
Text
id pubmed-8931220
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-89312202022-03-19 A Machine Learning-Based Prediction Model for Acute Kidney Injury in Patients With Congestive Heart Failure Peng, Xi Li, Le Wang, Xinyu Zhang, Huiping Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Machine learning (ML) has been used to build high performance prediction model. Patients with congestive heart failure (CHF) are vulnerable to acute kidney injury (AKI) which makes treatment difficult. We aimed to establish an ML-based prediction model for the early identification of AKI in patients with CHF. METHODS: Patients data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database, and patients with CHF were selected. Comparisons between several common ML classifiers were conducted to select the best prediction model. Recursive feature elimination (RFE) was used to select important prediction features. The model was improved using hyperparameters optimization (HPO). The final model was validated using an external validation set from the eICU Collaborative Research Database. The area under the receiver operating characteristic curve (AUROC), accuracy, calibration curve and decision curve analysis were used to evaluate prediction performance. Additionally, the final model was used to predict renal replacement therapy (RRT) requirement and to assess the short-term prognosis of patients with CHF. Finally, a software program was developed based on the selected features, which could intuitively report the probability of AKI. RESULTS: A total of 8,580 patients with CHF were included, among whom 2,364 were diagnosed with AKI. The LightGBM model showed the best prediction performance (AUROC = 0.803) among the 13 ML-based models. After RFE and HPO, the final model was established with 18 features including serum creatinine (SCr), blood urea nitrogen (BUN) and urine output (UO). The prediction performance of LightGBM was better than that of measuring SCr, UO or SCr combined with UO (AUROCs: 0.809, 0.703, 0.560 and 0.714, respectively). Additionally, the final model could accurately predict RRT requirement in patients with (AUROC = 0.954). Moreover, the participants were divided into high- and low-risk groups for AKI, and the 90-day mortality in the high-risk group was significantly higher than that in the low-risk group (log-rank p < 0.001). Finally, external validation using the eICU database comprising 9,749 patients with CHF revealed satisfactory prediction outcomes (AUROC = 0.816). CONCLUSION: A prediction model for AKI in patients with CHF was established based on LightGBM, and the prediction performance of this model was better than that of other models. This model may help in predicting RRT requirement and in identifying the population with poor prognosis among patients with CHF. Frontiers Media S.A. 2022-03-04 /pmc/articles/PMC8931220/ /pubmed/35310995 http://dx.doi.org/10.3389/fcvm.2022.842873 Text en Copyright © 2022 Peng, Li, Wang and Zhang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Peng, Xi
Li, Le
Wang, Xinyu
Zhang, Huiping
A Machine Learning-Based Prediction Model for Acute Kidney Injury in Patients With Congestive Heart Failure
title A Machine Learning-Based Prediction Model for Acute Kidney Injury in Patients With Congestive Heart Failure
title_full A Machine Learning-Based Prediction Model for Acute Kidney Injury in Patients With Congestive Heart Failure
title_fullStr A Machine Learning-Based Prediction Model for Acute Kidney Injury in Patients With Congestive Heart Failure
title_full_unstemmed A Machine Learning-Based Prediction Model for Acute Kidney Injury in Patients With Congestive Heart Failure
title_short A Machine Learning-Based Prediction Model for Acute Kidney Injury in Patients With Congestive Heart Failure
title_sort machine learning-based prediction model for acute kidney injury in patients with congestive heart failure
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8931220/
https://www.ncbi.nlm.nih.gov/pubmed/35310995
http://dx.doi.org/10.3389/fcvm.2022.842873
work_keys_str_mv AT pengxi amachinelearningbasedpredictionmodelforacutekidneyinjuryinpatientswithcongestiveheartfailure
AT lile amachinelearningbasedpredictionmodelforacutekidneyinjuryinpatientswithcongestiveheartfailure
AT wangxinyu amachinelearningbasedpredictionmodelforacutekidneyinjuryinpatientswithcongestiveheartfailure
AT zhanghuiping amachinelearningbasedpredictionmodelforacutekidneyinjuryinpatientswithcongestiveheartfailure
AT pengxi machinelearningbasedpredictionmodelforacutekidneyinjuryinpatientswithcongestiveheartfailure
AT lile machinelearningbasedpredictionmodelforacutekidneyinjuryinpatientswithcongestiveheartfailure
AT wangxinyu machinelearningbasedpredictionmodelforacutekidneyinjuryinpatientswithcongestiveheartfailure
AT zhanghuiping machinelearningbasedpredictionmodelforacutekidneyinjuryinpatientswithcongestiveheartfailure