Machine learning algorithm to predict the in-hospital mortality in critically ill patients with chronic kidney disease

Background This study aimed to establish and validate a machine learning (ML) model for predicting in-hospital mortality in critically ill patients with chronic kidney disease (CKD).Methods This study collected data on CKD patients from 2008 to 2019 using the Medical Information Mart for Intensive C...

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Bibliographic Details
Main Authors: Xunliang Li, Yuyu Zhu, Wenman Zhao, Rui Shi, Zhijuan Wang, Haifeng Pan, Deguang Wang
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2212790
Description
Summary:Background This study aimed to establish and validate a machine learning (ML) model for predicting in-hospital mortality in critically ill patients with chronic kidney disease (CKD).Methods This study collected data on CKD patients from 2008 to 2019 using the Medical Information Mart for Intensive Care IV. Six ML approaches were used to build the model. Accuracy and area under the curve (AUC) were used to choose the best model. In addition, the best model was interpreted using SHapley Additive exPlanations (SHAP) values.Results There were 8527 CKD patients eligible for participation; the median age was 75.1 (interquartile range: 65.0–83.5) years, and 61.7% (5259/8527) were male. We developed six ML models with clinical variables as input factors. Among the six models developed, the eXtreme Gradient Boosting (XGBoost) model had the highest AUC, at 0.860. According to the SHAP values, the sequential organ failure assessment score, urine output, respiratory rate, and simplified acute physiology score II were the four most influential variables in the XGBoost model.Conclusions In conclusion, we successfully developed and validated ML models for predicting mortality in critically ill patients with CKD. Among all ML models, the XGBoost model is the most effective ML model that can help clinicians accurately manage and implement early interventions, which may reduce mortality in critically ill CKD patients with a high risk of death.
ISSN:0886-022X
1525-6049