基于机器学习的乳酸预测早产儿新生儿死亡率实用性评估。

IF 2.3 4区 医学 Q2 PEDIATRICS
Moon-Yeon Oh, Sol Kim, Minsoo Kim, Yu Mi Seo, Sook Kyung Yum
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引用次数: 0

摘要

背景:与成人和儿科患者不同,乳酸对早产儿的作用尚未得到深入讨论。本研究旨在评估生命最初几小时的乳酸水平是否是与极低出生体重(VLBW)早产儿新生儿死亡相关的重要因素:方法:研究人员查阅了韩国一家四级新生儿重症监护病房的电子病历,以了解围产期和新生儿结局。收集了早产儿出生后 12 小时内的乳酸水平数据。根据乳酸水平比较了新生儿死亡率和发病率。随后,比较了包含和不包含乳酸的20个自变量的机器学习模型的性能,以及乳酸在适用模型中预测院内死亡率的特征重要性:结果:共纳入 168 名早产儿。出生后第 7 天和第 30 天的死亡率(D30-死亡率)在乳酸水平较高(≥第 3 次四分位数间范围)的婴儿中明显高于乳酸水平较低的婴儿:生命早期的乳酸水平可能是早产低体重儿院内死亡的重要相关因素。根据上述机器学习模型的增强性能,产后早期的乳酸水平可能有助于评估该人群的临床状况和预测住院过程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Machine-learning-based evaluation of the usefulness of lactate for predicting neonatal mortality in preterm infants.

Background: Unlike in adult and pediatric patients, the usefulness of lactate in preterm infants has not been thoroughly discussed. This study aimed to evaluate whether the lactate level in the first hours of life is an important factor associated with neonatal death in very-low-birth-weight (VLBW) preterm infants.

Methods: Electronic medical records from a level 4 neonatal intensive care unit in South Korea were reviewed to obtain perinatal and neonatal outcomes. Data on lactate levels of preterm infants in the first 12 h of life were collected. Neonatal mortality and morbidities were compared based on lactate levels. Subsequently, machine-learning models incorporating 20 independent variables, both with and without lactate, were compared for model performances and feature importance of lactate for predicting in-hospital mortality in the applicable models.

Results: One hundred and sixty-eight preterm infants were included. Death rates on days 7 and 30 of life (D30-mortality) were significantly higher in infants with high lactate levels (≥3rd interquartile range) than in those with lower levels (<3rd interquartile range). Though statistically insignificant, the overall in-hospital mortality was more than twice as high in the high lactate level group than in the lower lactate level group. Based on the machine learning results, Random Forest, Gradient Boosting, and LightGBM models all showed greater area under the curves when lactate was included. Lactate consistently ranked in the variables of top five feature importance, particularly showing the greatest value in the Gradient Boosting model.

Conclusion: Lactate levels during the early hours of life may be an important factor associated with in-hospital death of preterm VLBW infants. Based on the enhanced performance of the above-mentioned machine learning models, lactate levels in the early postnatal period may add to assessing the clinical status and predicting the hospital course in this population.

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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
170
审稿时长
48 days
期刊介绍: Pediatrics and Neonatology is the official peer-reviewed publication of the Taiwan Pediatric Association and The Society of Neonatology ROC, and is indexed in EMBASE and SCOPUS. Articles on clinical and laboratory research in pediatrics and related fields are eligible for consideration.
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