- Building a Prediction Model for Postoperative Acute Kidney Injury using Machine Learning
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Ji Won Min, Se-Hyun Chang, Jae-Hong Min, Byung Ha Chung, Eun Sil Koh, Young Soo Kim, Hyung Wook Kim, Tae Hyun Ban, Hye Eun Yoon
2021 ; 2021(1):
- 논문분류 :
- 춘계학술대회 초록집
Objective: In this retrospective cohort analysis, we included noncardiac surgeries performed between 2009 and 2019 at 7 university hospitals in South Korea. Postoperative AKI was defined as an increase of serum creatinine at least 1.5 times the baseline value or initiation of renal replacement therapy within 30 days of the postoperative period. We tested 6 machine learning prediction models: deep neural networks (DNN), logistic regression, decision tree, random forest, light gradient boosting machine (GBM), and naïve Bayes, and compared model performance using area under the curve (AUC) of the receiver-operating characteristic. Methods: A total of 239,267 surgeries were included, and 7,935 postoperative AKI events (3.3%) occurred. The 6 different statistical analysis methods were run on various combinations of 36 independent preoperative predictors that we had selected (Table 1). Model 1 included all variables, Model 2 included variables that had been significantly associated with postoperative AKI in previous studies, and Model 3 included variables that were found significant on multivariate analysis. Among them, Model 1 run on DNN (AUC = 0.821) and light GBM (AUC = 0.823) and Model 3 run on DNN (AUC = 0.807) demonstrated the best prediction performance. Results: We have developed a high-performance risk prediction system for postoperative AKI that can be easily applied using preoperative patient characteristics and laboratory data. Conclusions: Objective: Postoperative acute kidney injury (AKI) is associated with increased mortality and morbidity in patients undergoing surgeries performed under general anesthesia. There are several models that predict postoperative AKI risk, but most are single-center studies that need external validation. Methods: In this retrospective cohort analysis, we included noncardiac surgeries performed between 2009 and 2019 at 7 university hospitals in South Korea. Postoperative AKI was defined as an increase of serum creatinine at least 1.5 times the baseline value or initiation of renal replacement therapy within 30 days of the postoperative period. We tested 6 machine learning prediction models: deep neural networks (DNN), logistic regression, decision tree, random forest, light gradient boosting machine (GBM), and naïve Bayes, and compared model performance using area under the curve (AUC) of the receiver-operating characteristic. Results: A total of 239,267 surgeries were included, and 7,935 postoperative AKI events (3.3%) occurred. The 6 different statistical analysis methods were run on various combinations of 36 independent preoperative predictors that we had selected (Table 1). Model 1 included all variables, Model 2 included variables that had been significantly associated with postoperative AKI in previous studies, and Model 3 included variables that were found significant on multivariate analysis. Among them, Model 1 run on DNN (AUC = 0.821) and light GBM (AUC = 0.823) and Model 3 run on DNN (AUC = 0.807) demonstrated the best prediction performance. Conclusions: We have developed a high-performance risk prediction system for postoperative AKI that can be easily applied using preoperative patient characteristics and laboratory data.