Machine learning prediction of moderate-to-severe acute kidney injury after ICU admission and cardiac surgery with urine trace elements.

IF 3.6 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Yang Chen, Ying Gue, Gregory Y H Lip, David S Gardner, Mark A J Devonald
{"title":"Machine learning prediction of moderate-to-severe acute kidney injury after ICU admission and cardiac surgery with urine trace elements.","authors":"Yang Chen, Ying Gue, Gregory Y H Lip, David S Gardner, Mark A J Devonald","doi":"10.1111/eci.70131","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is common and linked to poor outcomes, but early detection remains challenging. Previous research identified urinary trace elements (TE) as early AKI biomarkers in intensive care unit (ICU) or cardiac surgery patients. We aimed to explore whether urinary TE enhance machine learning (ML) models for AKI prediction.</p><p><strong>Methods: </strong>We constructed ML models using the ICU cohort. We filtered the variables and optimized hyperparameters before predicting Kidney Disease: Improving Global Outcomes stage 2-3 AKI using eight ML classifiers: light gradient boosting machine (LightGBM), random forest (RF), ML logistic regression, support vector machine, multilayer perceptron, eXtreme gradient boosting (XGBoost), Gaussian Naive Bayes and k-nearest neighbors. External validation was performed in the cardiac surgery cohort.</p><p><strong>Results: </strong>Among 149 ICU patients (median age 56.0 [interquartile range (IQR): 43.5-67.0], 63.1% male), 25 developed stage 2-3 AKI; among 144 cardiac surgery patients (median age 70.0 [IQR: 62.0-76.0], 72.9% male), 12 developed stage 2-3 AKI. Each ML in the internal validation had area under the curve (AUC) above .7, with XGBoost having the highest (.813); LightGBM had the second highest AUC (.799), highest G-mean (.567) and F1-score (.545). In external validation, RF had the highest AUC (.740), XGBoost had the highest G-mean (.289) and F1-score (.286). Age, strontium and boron were consistently ranked among the top five most important features in LightGBM, RF and XGBoost.</p><p><strong>Conclusion: </strong>ML models primarily based on urinary TE can identify AKI risk in both clinical groups (ICU and cardiac surgery), with LightGBM, RF and XGBoost serving as high-performance models for early prediction of stage 2-3 AKI.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70131"},"PeriodicalIF":3.6000,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Clinical Investigation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/eci.70131","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Acute kidney injury (AKI) is common and linked to poor outcomes, but early detection remains challenging. Previous research identified urinary trace elements (TE) as early AKI biomarkers in intensive care unit (ICU) or cardiac surgery patients. We aimed to explore whether urinary TE enhance machine learning (ML) models for AKI prediction.

Methods: We constructed ML models using the ICU cohort. We filtered the variables and optimized hyperparameters before predicting Kidney Disease: Improving Global Outcomes stage 2-3 AKI using eight ML classifiers: light gradient boosting machine (LightGBM), random forest (RF), ML logistic regression, support vector machine, multilayer perceptron, eXtreme gradient boosting (XGBoost), Gaussian Naive Bayes and k-nearest neighbors. External validation was performed in the cardiac surgery cohort.

Results: Among 149 ICU patients (median age 56.0 [interquartile range (IQR): 43.5-67.0], 63.1% male), 25 developed stage 2-3 AKI; among 144 cardiac surgery patients (median age 70.0 [IQR: 62.0-76.0], 72.9% male), 12 developed stage 2-3 AKI. Each ML in the internal validation had area under the curve (AUC) above .7, with XGBoost having the highest (.813); LightGBM had the second highest AUC (.799), highest G-mean (.567) and F1-score (.545). In external validation, RF had the highest AUC (.740), XGBoost had the highest G-mean (.289) and F1-score (.286). Age, strontium and boron were consistently ranked among the top five most important features in LightGBM, RF and XGBoost.

Conclusion: ML models primarily based on urinary TE can identify AKI risk in both clinical groups (ICU and cardiac surgery), with LightGBM, RF and XGBoost serving as high-performance models for early prediction of stage 2-3 AKI.

尿微量元素对ICU入院及心脏手术后中重度急性肾损伤的机器学习预测。
背景:急性肾损伤(AKI)很常见,且与不良预后有关,但早期发现仍然具有挑战性。先前的研究发现尿微量元素(TE)是重症监护病房(ICU)或心脏手术患者早期AKI的生物标志物。我们的目的是探讨尿TE是否增强了AKI预测的机器学习(ML)模型。方法:采用ICU队列构建ML模型。在预测肾脏疾病:改善全球结果2-3期AKI之前,我们过滤了变量并优化了超参数,使用了8个ML分类器:光梯度增强机(LightGBM)、随机森林(RF)、ML逻辑回归、支持向量机、多层感知机、极端梯度增强(XGBoost)、高斯朴素贝叶斯和k近邻。在心脏外科队列中进行外部验证。结果:149例ICU患者(中位年龄56.0岁[四分位间距43.5 ~ 67.0],男性占63.1%),25例发生2-3期AKI;144例心脏手术患者(中位年龄70.0岁[IQR: 62.0 ~ 76.0],男性72.9%),12例发展为2-3期AKI。内验证的每个ML均具有上述曲线下面积(AUC)。7,其中XGBoost最高(.813);LightGBM的AUC次之。799),最高G-mean(.567)和F1-score(.545)。在外部验证中,RF具有最高的AUC(。XGBoost的g均值最高(0.289),f1评分最高(0.286)。在LightGBM、RF和XGBoost中,年龄、锶和硼一直排在前五大最重要的特征之列。结论:主要基于尿TE的ML模型可以识别临床组(ICU和心脏外科)的AKI风险,其中LightGBM、RF和XGBoost是早期预测2-3期AKI的高性能模型。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
9.50
自引率
3.60%
发文量
192
审稿时长
1 months
期刊介绍: EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信