Development and performance assessment of novel machine learning models for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage patients: external validation in MIMIC-IV
BackgroundPostoperative pneumonia (POP) is one of the primary complications after aneurysmal subarachnoid hemorrhage (aSAH) and is associated with postoperative mortality, extended hospital stay, and increased medical fee. Early identification of pneumonia and more aggressive treatment can improve p...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1341252/full |
| _version_ | 1797208819142492160 |
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| author | Xinbo Li Xinbo Li Chengwei Zhang Chengwei Zhang Jiale Wang Jiale Wang Chengxing Ye Chengxing Ye Jiaqian Zhu Qichuan Zhuge Qichuan Zhuge |
| author_facet | Xinbo Li Xinbo Li Chengwei Zhang Chengwei Zhang Jiale Wang Jiale Wang Chengxing Ye Chengxing Ye Jiaqian Zhu Qichuan Zhuge Qichuan Zhuge |
| author_sort | Xinbo Li |
| collection | DOAJ |
| description | BackgroundPostoperative pneumonia (POP) is one of the primary complications after aneurysmal subarachnoid hemorrhage (aSAH) and is associated with postoperative mortality, extended hospital stay, and increased medical fee. Early identification of pneumonia and more aggressive treatment can improve patient outcomes. We aimed to develop a model to predict POP in aSAH patients using machine learning (ML) methods.MethodsThis internal cohort study included 706 patients with aSAH undergoing intracranial aneurysm embolization or aneurysm clipping. The cohort was randomly split into a train set (80%) and a testing set (20%). Perioperative information was collected from participants to establish 6 machine learning models for predicting POP after surgical treatment. The area under the receiver operating characteristic curve (AUC), precision-recall curve were used to assess the accuracy, discriminative power, and clinical validity of the predictions. The final model was validated using an external validation set of 97 samples from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database.ResultsIn this study, 15.01% of patients in the training set and 12.06% in the testing set with POP after underwent surgery. Multivariate logistic regression analysis showed that mechanical ventilation time (MVT), Glasgow Coma Scale (GCS), Smoking history, albumin level, neutrophil-to-albumin Ratio (NAR), c-reactive protein (CRP)-to-albumin ratio (CAR) were independent predictors of POP. The logistic regression (LR) model presented significantly better predictive performance (AUC: 0.91) than other models and also performed well in the external validation set (AUC: 0.89).ConclusionA machine learning model for predicting POP in aSAH patients was successfully developed using a machine learning algorithm based on six perioperative variables, which could guide high-risk POP patients to take appropriate preventive measures. |
| first_indexed | 2024-04-24T09:44:52Z |
| format | Article |
| id | doaj.art-d9d0ff1b11d14e90850c8ed13bce3fe6 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-24T09:44:52Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-d9d0ff1b11d14e90850c8ed13bce3fe62024-04-15T04:12:18ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-04-011510.3389/fneur.2024.13412521341252Development and performance assessment of novel machine learning models for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage patients: external validation in MIMIC-IVXinbo Li0Xinbo Li1Chengwei Zhang2Chengwei Zhang3Jiale Wang4Jiale Wang5Chengxing Ye6Chengxing Ye7Jiaqian Zhu8Qichuan Zhuge9Qichuan Zhuge10Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaWenzhou Medical University, Wenzhou, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaWenzhou Medical University, Wenzhou, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaWenzhou Medical University, Wenzhou, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaWenzhou Medical University, Wenzhou, ChinaWenzhou Medical University, Wenzhou, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, ChinaWenzhou Medical University, Wenzhou, ChinaBackgroundPostoperative pneumonia (POP) is one of the primary complications after aneurysmal subarachnoid hemorrhage (aSAH) and is associated with postoperative mortality, extended hospital stay, and increased medical fee. Early identification of pneumonia and more aggressive treatment can improve patient outcomes. We aimed to develop a model to predict POP in aSAH patients using machine learning (ML) methods.MethodsThis internal cohort study included 706 patients with aSAH undergoing intracranial aneurysm embolization or aneurysm clipping. The cohort was randomly split into a train set (80%) and a testing set (20%). Perioperative information was collected from participants to establish 6 machine learning models for predicting POP after surgical treatment. The area under the receiver operating characteristic curve (AUC), precision-recall curve were used to assess the accuracy, discriminative power, and clinical validity of the predictions. The final model was validated using an external validation set of 97 samples from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database.ResultsIn this study, 15.01% of patients in the training set and 12.06% in the testing set with POP after underwent surgery. Multivariate logistic regression analysis showed that mechanical ventilation time (MVT), Glasgow Coma Scale (GCS), Smoking history, albumin level, neutrophil-to-albumin Ratio (NAR), c-reactive protein (CRP)-to-albumin ratio (CAR) were independent predictors of POP. The logistic regression (LR) model presented significantly better predictive performance (AUC: 0.91) than other models and also performed well in the external validation set (AUC: 0.89).ConclusionA machine learning model for predicting POP in aSAH patients was successfully developed using a machine learning algorithm based on six perioperative variables, which could guide high-risk POP patients to take appropriate preventive measures.https://www.frontiersin.org/articles/10.3389/fneur.2024.1341252/fullaneurysmal subarachnoid hemorrhagepostoperative pneumoniamachine learningendovascular treatmentprediction |
| spellingShingle | Xinbo Li Xinbo Li Chengwei Zhang Chengwei Zhang Jiale Wang Jiale Wang Chengxing Ye Chengxing Ye Jiaqian Zhu Qichuan Zhuge Qichuan Zhuge Development and performance assessment of novel machine learning models for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage patients: external validation in MIMIC-IV Frontiers in Neurology aneurysmal subarachnoid hemorrhage postoperative pneumonia machine learning endovascular treatment prediction |
| title | Development and performance assessment of novel machine learning models for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage patients: external validation in MIMIC-IV |
| title_full | Development and performance assessment of novel machine learning models for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage patients: external validation in MIMIC-IV |
| title_fullStr | Development and performance assessment of novel machine learning models for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage patients: external validation in MIMIC-IV |
| title_full_unstemmed | Development and performance assessment of novel machine learning models for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage patients: external validation in MIMIC-IV |
| title_short | Development and performance assessment of novel machine learning models for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage patients: external validation in MIMIC-IV |
| title_sort | development and performance assessment of novel machine learning models for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage patients external validation in mimic iv |
| topic | aneurysmal subarachnoid hemorrhage postoperative pneumonia machine learning endovascular treatment prediction |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1341252/full |
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