Using a Machine Learning Approach to Predict Snakebite Envenoming Outcomes Among Patients Attending the Snakebite Treatment and Research Hospital in Kaltungo, Northeastern Nigeria.

IF 2.8 4区 医学 Q2 INFECTIOUS DISEASES
Nicholas Amani Hamman, Aashna Uppal, Nuhu Mohammed, Abubakar Saidu Ballah, Danimoh Mustapha Abdulsalam, Frank Mela Dangabar, Nuhu Barde, Bello Abdulkadir, Suraj Abdullahi Abdulkarim, Habu Dahiru, Idris Mohammed, Trudie Lang, Joshua Abubakar Difa
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Abstract

The Snakebite Treatment and Research Hospital (SBTRH) is a leading centre for snakebite envenoming care and research in sub-Saharan Africa, treating over 2500 snakebite patients annually. Despite routine data collection, routine analyses are seldom conducted to identify trends or guide clinical practices. This study retrospectively analyzes 1022 snakebite cases at SBTRH from January to June 2024. Most patients were adults (62%) and were predominantly male (72%). Key factors such as age, sex, and time between bite and hospital presentation were associated with outcomes, including recovery, amputation, debridement, and death. Adult males who took more than four hours to arrive to hospital were identified as a high-risk group for poor outcomes. Using patient characteristics, an XGBoost model was developed and was compared to Random Forest and logistic regression models. In general, all models had high positive predictive value and low sensitivity, meaning that if they predicted a patient to experience amputation, debridement, or death, that patient almost always actually experienced amputation, debridement, or death; however, most models rarely made this prediction. The XGBoost model with all features was optimal, given that it had both a high positive predictive value and relatively high sensitivity. This may be of significance to resource-limited settings like SBTRH, where antivenoms can be scarce; however, more research is needed to build better predictive models. These findings underscore the need for targeted interventions for high-risk groups, and further research and integration of machine-learning-driven decision support tools in low-resource-limited clinical settings.

在尼日利亚东北部Kaltungo的蛇咬伤治疗和研究医院,使用机器学习方法预测蛇咬伤患者的结局。
蛇咬伤治疗和研究医院(SBTRH)是撒哈拉以南非洲地区蛇咬伤护理和研究的领先中心,每年治疗2500多名蛇咬伤患者。尽管常规数据收集,常规分析很少进行,以确定趋势或指导临床实践。本研究回顾性分析了2024年1 - 6月SBTRH 1022例蛇咬伤病例。大多数患者为成年人(62%),以男性为主(72%)。关键因素如年龄、性别、咬伤和住院之间的时间与康复、截肢、清创和死亡等结果相关。到达医院的时间超过4小时的成年男性被确定为预后不良的高危人群。根据患者特征,建立了XGBoost模型,并与随机森林模型和逻辑回归模型进行了比较。总的来说,所有模型都具有较高的阳性预测值和较低的敏感性,这意味着如果他们预测患者会经历截肢、清创或死亡,那么该患者几乎总是实际经历了截肢、清创或死亡;然而,大多数模型很少做出这样的预测。具有所有特征的XGBoost模型是最优的,因为它具有较高的正预测值和相对较高的灵敏度。这可能对资源有限的环境具有重要意义,如SBTRH,在那里抗蛇毒血清可能稀缺;然而,需要更多的研究来建立更好的预测模型。这些发现强调了对高危人群进行针对性干预的必要性,以及在低资源有限的临床环境中进一步研究和整合机器学习驱动的决策支持工具的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Tropical Medicine and Infectious Disease
Tropical Medicine and Infectious Disease Medicine-Public Health, Environmental and Occupational Health
CiteScore
3.90
自引率
10.30%
发文量
353
审稿时长
11 weeks
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