单位:[1]Department of Emergency, The First Medical Center of Chinese PLA General Hospital, Beijing, China[2]School of Economics and Management, Beijing Jiaotong University, Beijing, China[3]Management School, Beijing Union University, Beijing, China[4]Washington University in St. Louis[5]Department of Emergency, Armed Police Characteristic Medical Center, Tianjin, China[6]College of Computer Science and Artificial Intelligence, Wenzhou University[7]Beijing Friendship Hospital, Capital Medical University, Beijing, China首都医科大学附属北京友谊医院[8]Department of Emergency, The Third Medical Center of Chinese PLA General Hospital, Beijing, China[9]Hainan Hospital of Chinese PLA General Hospital, Sanya, China
Early warning prediction of traumatic hemorrhagic shock (THS) can greatly reduce patient mortality and morbidity. We aimed to develop and validate models with different stepped feature sets to predict THS in advance. From the PLA General Hospital Emergency Rescue Database and Medical Information Mart for Intensive Care III, we identified 604 and 1,614 patients, respectively. Two popular machine learning algorithms (i.e., extreme gradient boosting [XGBoost] and logistic regression) were applied. The area under the receiver operating characteristic curve (AUROC) was used to evaluate the performance of the models. By analyzing the feature importance based on XGBoost, we found that features in vital signs (VS), routine blood (RB), and blood gas analysis (BG) were the most relevant to THS (0.292, 0.249, and 0.225, respectively). Thus, the stepped relationships existing in them were revealed. Furthermore, the three stepped feature sets (i.e., VS, VS + RB, and VS + RB + sBG) were passed to the two machine learning algorithms to predict THS in the subsequent T hours (where T = 3, 2, 1, or 0.5), respectively. Results showed that the XGBoost model performance was significantly better than the logistic regression. The model using vital signs alone achieved good performance at the half-hour time window (AUROC = 0.935), and the performance was increased when laboratory results were added, especially when the time window was 1 h (AUROC = 0.950 and 0.968, respectively). These good-performing interpretable models demonstrated acceptable generalization ability in external validation, which could flexibly and rollingly predict THS T hours (where T = 0.5, 1) prior to clinical recognition. A prospective study is necessary to determine the clinical utility of the proposed THS prediction models.
基金:
National Key Research and Development Plan for Science and TechnologyWinter Olympics of the Ministry of Science and Technology of China [2019YFF0302301]; Natural Science Foundation of Hainan Province [818MS156]; Special Fund for Health Care of the Ministry of Logistics [16BJZ19]
语种:
外文
被引次数:
WOS:
PubmedID:
中科院(CAS)分区:
出版当年[2021]版:
大类|2 区医学
小类|2 区外科3 区危重病医学3 区血液学3 区外周血管病
最新[2025]版:
大类|3 区医学
小类|3 区血液学3 区外周血管病3 区外科4 区危重病医学
JCR分区:
出版当年[2020]版:
Q2HEMATOLOGYQ2PERIPHERAL VASCULAR DISEASEQ2CRITICAL CARE MEDICINEQ2SURGERY
最新[2023]版:
Q1SURGERYQ2CRITICAL CARE MEDICINEQ2HEMATOLOGYQ2PERIPHERAL VASCULAR DISEASE
第一作者单位:[1]Department of Emergency, The First Medical Center of Chinese PLA General Hospital, Beijing, China
共同第一作者:
通讯作者:
通讯机构:[1]Department of Emergency, The First Medical Center of Chinese PLA General Hospital, Beijing, China[2]School of Economics and Management, Beijing Jiaotong University, Beijing, China[8]Department of Emergency, The Third Medical Center of Chinese PLA General Hospital, Beijing, China[9]Hainan Hospital of Chinese PLA General Hospital, Sanya, China[*1]School of Economics and Management, Beijing Jiaotong University, Beijing, China.[*2]Department of Emergency, The Third Medical Center of Chinese PLA General Hospital, Beijing, China Department of Emergency, Hainan Hospital of Chinese PLA General Hospital, Sanya, China.[*3]Department of Emergency, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
推荐引用方式(GB/T 7714):
Zhao Yuzhuo,Jia Lijing,Jia Ruiqi,et al.A New Time-Window Prediction Model For Traumatic Hemorrhagic Shock Based on Interpretable Machine Learning[J].SHOCK.2022,57(1):48-56.doi:10.1097/SHK.0000000000001842.
APA:
Zhao Yuzhuo,Jia Lijing,Jia Ruiqi,Han Hui,Feng Cong...&Li Tanshi.(2022).A New Time-Window Prediction Model For Traumatic Hemorrhagic Shock Based on Interpretable Machine Learning.SHOCK,57,(1)
MLA:
Zhao Yuzhuo,et al."A New Time-Window Prediction Model For Traumatic Hemorrhagic Shock Based on Interpretable Machine Learning".SHOCK 57..1(2022):48-56