Machine learning-based model to predict severe acute kidney injury after total aortic arch replacement for acute type A aortic dissection

Autor: Xiaolong Liu, Miaoxian Fang, Kai Wang, Junjiang Zhu, Zeling Chen, Linling He, Silin Liang, Yiyu Deng, Chunbo Chen
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Heliyon, Vol 10, Iss 13, Pp e34171- (2024)
Druh dokumentu: article
ISSN: 2405-8440
DOI: 10.1016/j.heliyon.2024.e34171
Popis: Background: Severe acute kidney injury (AKI) after total aortic arch replacement (TAAR) is related to adverse outcomes in patients with acute type A aortic dissection (ATAAD). However, the early prediction of severe AKI remains a challenge. This study aimed to develop a novel model to predict severe AKI after TAAR in ATAAD patients using machine learning algorithms. Methods: A total of 572 ATAAD patients undergoing TAAR were enrolled in this retrospective study, and randomly divided into a training set (70 %) and a validation set (30 %). Lasso regression, support vector machine-recursive feature elimination and random forest algorithms were used to screen indicators for severe AKI (defined as AKI stage III) in the training set, respectively. Then the intersection indicators were selected to construct models through artificial neural network (ANN) and logistic regression. The AUC-ROC curve was employed to ascertain the prediction efficacy of the ANN and logistic regression models. Results: The incidence of severe AKI after TAAR was 22.9 % among ATAAD patients. The intersection predictors identified by different machine learning algorithms were baseline serum creatinine and ICU admission variables, including serum cystatin C, procalcitonin, aspartate transaminase, platelet, lactic dehydrogenase, urine N-acetyl-β-d-glucosidase and Acute Physiology and Chronic Health Evaluation II score. The ANN model showed a higher AUC-ROC than logistic regression (0.938 vs 0.908, p
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