基于机器学习算法建立非肝脏手术术后肝损伤风险预测模型

孙义竹; 李雨捷; 梁浩; 刘祥; 黄家号; 舒欣; 宋艾璘; 杨智勇; 易斌

doi:10.16016/j.2097-0927.202312018

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基于机器学习算法建立非肝脏手术术后肝损伤风险预测模型

临床医学 | 更新时间：2026-01-09

- 基于机器学习算法建立非肝脏手术术后肝损伤风险预测模型
- Establishment of risk prediction model for postoperative liver injury after non-liver surgery based on different machine learning algorithms
- 陆军军医大学学报 2024年46卷第7期页码：760-767
- 作者机构：
  
  400038 重庆, 陆军军医大学(第三军医大学)第一附属医院麻醉科
- 作者简介：
  
  [易斌，E-mail：yibin1974@163.comYI Bin, E-mail: yibin1974@163.com
- 基金信息：
  
  国家重点研发计划(2018YFC0116702)
- DOI：10.16016/j.2097-0927.202312018
  中图分类号： R181.32;R319;R575
- 收稿：2023-12-04，
  
  修回：2024-02-09，
  
  纸质出版：2024-04-15
- 稿件说明：
移动端阅览
孙义竹, 李雨捷, 梁浩, 等. 基于机器学习算法建立非肝脏手术术后肝损伤风险预测模型[J]. 陆军军医大学学报, 2024,46(7):760-767.

Yizhu SUN, Yujie LI, Hao LIANG, et al. Establishment of risk prediction model for postoperative liver injury after non-liver surgery based on different machine learning algorithms[J]. Journal of Army Medical University, 2024, 46(7): 760-767.
孙义竹, 李雨捷, 梁浩, 等. 基于机器学习算法建立非肝脏手术术后肝损伤风险预测模型[J]. 陆军军医大学学报, 2024,46(7):760-767. DOI： 10.16016/j.2097-0927.202312018.

Yizhu SUN, Yujie LI, Hao LIANG, et al. Establishment of risk prediction model for postoperative liver injury after non-liver surgery based on different machine learning algorithms[J]. Journal of Army Medical University, 2024, 46(7): 760-767. DOI： 10.16016/j.2097-0927.202312018.

摘要

目的

基于术前及术中用药指标建立一个预测非肝脏手术患者术后肝损伤的机器学习预测模型。

方法

采用病例-对照研究设计方案

选择国内3家大型综合医院开发的数据库中2014年1月至2022年9月行非肝脏手术术后出现肝损伤患者315例

按阳性: 阴性为1:3的比例随机匹配同期非肝脏手术术后未发生肝损伤的928例病例作为阴性对照病例。将这1 243例患者根据R语言设置的代码以7:3的比例随机拆分为建模组(

=869)和验证组(

=374)。利用患者术前临床指标(基本信息、病史、相关评分表、手术相关信息和实验室检查)及术中用药情况基于k-近邻(k-nearest neighbor

KNN)、支持向量机(support vector machine linear

SVM)、逻辑回归(logistic regression

LR)、极端梯度提升(extreme gradient boosting

XGBoost)4种机器学习算法建立预测非肝脏手术术后肝损伤的模型

并在验证组通过受试者工作特征曲线(receiver operating characteristic

ROC)、精准-召回曲线(percision-recall curve

P-R)、临床决策分析曲线(decision curve analysis

DCA)、Kappa值、灵敏度、特异度、Brier分数、F

分数对模型效能进行评估。

结果

4种机器学习算法建立的预测非肝脏手术术后肝损伤的模型以XGBoost算法最优

验证组中受试者工作特征曲线下面积(area under the receiver operating characteristic curve

AUROC)为0.916(95%

: 0.883~0.949)

精准-召回曲线下面积(area under the precision-recall curve

AUPRC)为0.841

Brier评分0.097

灵敏度和特异度分别为78.95%和87.10%。

结论

基于XGBoost算法建立的非肝脏手术术后肝损伤预测模型对术后肝损伤的发生有良好的预测能力。

Abstract

Objective

To construct a machine learning prediction model for postoperative liver injury in patients with non-liver surgery based on preoperative and intraoperative medication indicators.

Methods

A case-control study was conducted on 315 patients with liver injury after non-liver surgery selected from the databases developed by 3 large general hospitals from January 2014 to Sept

ember 2022.With the positive/negative ratio of 1:3

928 cases in corresponding period with non-liver surgery and without liver injury were randomly matched as negative control cases.These 1 243 patients were randomly divided into the modeling group (

=869) and the validation group (

=374) in a ratio of 7:3 using the R language setting code.Preoperative clinical indicators (basic information

medical history

relevant scale score

surgical information and results of laboratory tests) and intraoperative medication were used to construct the prediction model for liver injury after non-liver surgery based on 4 machine learning algorithms

k-nearest neighbor (KNN)

support vector machine linear (SVM)

logic regression (LR) and extreme gradient boosting (XGBoost).In the validation group

receiver operating characteristic (ROC) curve

precision-recall curve (P-R)

decision curve analysis (DCA) curve

Kappa value

sensitivity

specificity

Brier score

and F

score were applied to evaluate the efficacy of model.

Results

The model established by 4 machine learning algorithms to predict postoperative liver injury after non-liver surgery was optimal using the XGBoost algorithm.The area under the receiver operating characteristic curve (AUROC) was 0.916(95%

: 0.883~0.949)

area under the precision-recall curve (AUPRC) was 0.841

Brier score was 0.097

and sensitivity and specificity was 78.95% and 87.10%

respectively.

Conclusion

The postoperative liver injury prediction model for non-liver surgery based on the XGBoost algorithm has effective prediction for the occurrence of postoperative liver injury.

关键词

Keywords

references

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