Machine learning approach for predicting inhalation injury in patients with burns.

Autor: Yang SY; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC., Huang CJ; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC., Yen CI; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC., Kao YC; Muen Biomedical and Optoelectronic Technologies Inc, China., Hsiao YC; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC., Yang JY; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC., Chang SY; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC., Chuang SS; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC., Chen HC; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC. Electronic address: firepigtw@gmail.com.
Jazyk: angličtina
Zdroj: Burns : journal of the International Society for Burn Injuries [Burns] 2023 Nov; Vol. 49 (7), pp. 1592-1601. Date of Electronic Publication: 2023 Mar 22.
DOI: 10.1016/j.burns.2023.03.011
Abstrakt: Background: The coronavirus disease pandemic has had a tangible impact on bronchoscopy for burn inpatients due to isolation and triage measures. We utilised the machine-learning approach to identify risk factors for predicting mild and severe inhalation injury and whether patients with burns experienced inhalation injury. We also examined the ability of two dichotomous models to predict clinical outcomes including mortality, pneumonia, and duration of hospitalisation.
Methods: A retrospective 14-year single-centre dataset of 341 intubated patients with burns with suspected inhalation injury was established. The medical data on day one of admission and bronchoscopy-diagnosed inhalation injury grade were compiled using a gradient boosting-based machine-learning algorithm to create two prediction models: model 1, mild vs. severe inhalation injury; and model 2, no inhalation injury vs. inhalation injury.
Results: The area under the curve (AUC) for model 1 was 0·883, indicating excellent discrimination. The AUC for model 2 was 0·862, indicating acceptable discrimination. In model 1, the incidence of pneumonia (P < 0·001) and mortality rate (P < 0·001), but not duration of hospitalisation (P = 0·1052), were significantly higher in patients with severe inhalation injury. In model 2, the incidence of pneumonia (P < 0·001), mortality (P < 0·001), and duration of hospitalisation (P = 0·021) were significantly higher in patients with inhalation injury.
Conclusions: We developed the first machine-learning tool for differentiating between mild and severe inhalation injury, and the absence/presence of inhalation injury in patients with burns, which is helpful when bronchoscopy is not available immediately. The dichotomous classification predicted by both models was associated with the clinical outcomes.
Competing Interests: Conflicts of interest The authors have no conflicts of interest to declare.
(Copyright © 2023 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)
Databáze: MEDLINE
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