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Montomoli J, Romeo L, Moccia S, Bernardini M, Migliorelli L, Berardini D, Donati A, Carsetti A, Bocci MG, Wendel Garcia PD, Fumeaux T, Guerci P, Schüpbach RA, Ince C, Frontoni E, Hilty MP, Vizmanos-Lamotte G, Tschoellitsch T, Meier J, Aguirre-Bermeo H, Apolo J, Martínez A, Jurkolow G, Delahaye G, Novy E, Losser MR, Wengenmayer T, Rilinger J, Staudacher DL, David S, Welte T, Stahl K, Pavlos” “A, Aslanidis T, Korsos A, Babik B, Nikandish R, Rezoagli E, Giacomini M, Nova A, Fogagnolo A, Spadaro S, Ceriani R, Murrone M, Wu MA, Cogliati C, Colombo R, Catena E, Turrini F, Simonini MS, Fabbri S, Potalivo A, Facondini F, Gangitano G, Perin T, Grazia Bocci M, Antonelli M, Gommers D, Rodríguez-García R, Gámez-Zapata J, Taboada-Fraga X, Castro P, Tellez A, Lander-Azcona A, Escós-Orta J, Martín-Delgado MC, Algaba-Calderon A, Franch-Llasat D, Roche-Campo F, Lozano-Gómez H, Zalba-Etayo B, Michot MP, Klarer A, Ensner R, Schott P, Urech S, Zellweger N, Merki L, Lambert A, Laube M, Jeitziner MM, Jenni-Moser B, Wiegand J, Yuen B, Lienhardt-Nobbe B, Westphalen A, Salomon P, Drvaric I, Hillgaertner F, Sieber M, Dullenkopf A, Petersen L, Chau I, Ksouri H, Sridharan GO, Cereghetti S, Boroli F, Pugin J, Grazioli S, Rimensberger PC, Bürkle C, Marrel J, Brenni M, Fleisch I, Lavanchy J, Perez MH, Ramelet AS, Weber AB, Gerecke P, Christ A, Ceruti S, Glotta A, Marquardt K, Shaikh K, Hübner T, Neff T, Redecker H, Moret-Bochatay M, Bentrup FZ, Studhalter M, Stephan M, Brem J, Gehring N, Selz D, Naon D, Kleger GR, Pietsch U, Filipovic M, Ristic A, Sepulcri M, Heise A, Franchitti Laurent M, Laurent JC, Wendel Garcia PD, Schuepbach R, Heuberger D, Bühler P, Brugger S, Fodor P, Locher P, Camen G, Gaspert T, Jovic M, Haberthuer C, Lussman RF, Colak E. Machine learning using the extreme gradient boosting (XGBoost) algorithm predicts 5-day delta of SOFA score at ICU admission in COVID-19 patients. J Intensive Med 2021; 1:110-116. [PMID: 36785563 PMCID: PMC8531027 DOI: 10.1016/j.jointm.2021.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/20/2021] [Accepted: 09/06/2021] [Indexed: 02/08/2023]
Abstract
Background Accurate risk stratification of critically ill patients with coronavirus disease 2019 (COVID-19) is essential for optimizing resource allocation, delivering targeted interventions, and maximizing patient survival probability. Machine learning (ML) techniques are attracting increased interest for the development of prediction models as they excel in the analysis of complex signals in data-rich environments such as critical care. Methods We retrieved data on patients with COVID-19 admitted to an intensive care unit (ICU) between March and October 2020 from the RIsk Stratification in COVID-19 patients in the Intensive Care Unit (RISC-19-ICU) registry. We applied the Extreme Gradient Boosting (XGBoost) algorithm to the data to predict as a binary outcome the increase or decrease in patients' Sequential Organ Failure Assessment (SOFA) score on day 5 after ICU admission. The model was iteratively cross-validated in different subsets of the study cohort. Results The final study population consisted of 675 patients. The XGBoost model correctly predicted a decrease in SOFA score in 320/385 (83%) critically ill COVID-19 patients, and an increase in the score in 210/290 (72%) patients. The area under the mean receiver operating characteristic curve for XGBoost was significantly higher than that for the logistic regression model (0.86 vs. 0.69, P < 0.01 [paired t-test with 95% confidence interval]). Conclusions The XGBoost model predicted the change in SOFA score in critically ill COVID-19 patients admitted to the ICU and can guide clinical decision support systems (CDSSs) aimed at optimizing available resources.
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Affiliation(s)
- Jonathan Montomoli
- Department of Anaesthesia and Intensive Care, Infermi Hospital, AUSL della Romagna, Rimini 47923, Italy
| | - Luca Romeo
- Department of Information Engineering, Università Politecnica delle Marche, Ancona 60131, Italy
| | - Sara Moccia
- Department of Information Engineering, Università Politecnica delle Marche, Ancona 60131, Italy,The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa 56127, Italy
| | - Michele Bernardini
- Department of Information Engineering, Università Politecnica delle Marche, Ancona 60131, Italy
| | - Lucia Migliorelli
- Department of Information Engineering, Università Politecnica delle Marche, Ancona 60131, Italy
| | - Daniele Berardini
- Department of Information Engineering, Università Politecnica delle Marche, Ancona 60131, Italy
| | - Abele Donati
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona 60126, Italy,Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona 60126, Italy
| | - Andrea Carsetti
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona 60126, Italy,Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona 60126, Italy
| | - Maria Grazia Bocci
- Department of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | | | - Thierry Fumeaux
- Swiss Society of Intensive Care Medicine, Basel 4001, Switzerland
| | - Philippe Guerci
- Department of Anesthesiology and Critical Care Medicine, University Hospital of Nancy, Nancy 54511, France
| | - Reto Andreas Schüpbach
- Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich 8091, Switzerland
| | - Can Ince
- Department of Intensive Care Erasmus MC, University Medical Center Rotterdam, Rotterdam, 3015 GD, Netherlands,Corresponding author: Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
| | - Emanuele Frontoni
- Department of Information Engineering, Università Politecnica delle Marche, Ancona 60131, Italy
| | - Matthias Peter Hilty
- Institute of Intensive Care Medicine, University Hospital of Zurich, Zurich 8091, Switzerland
| | - RISC-19-ICU InvestigatorsAlfaro-FariasMarioMDVizmanos-LamotteGerardoMD, PhDTschoellitschThomasMDMeierJensMDAguirre-BermeoHernánMD, PhDApoloJaninaBScMartínezAlbertoMDJurkolowGeoffreyMDDelahayeGauthierMDNovyEmmanuelMDLosserMarie-ReineMD, PhDWengenmayerTobiasMDRilingerJonathanMDStaudacherDawid L.MDDavidSaschaMDWelteTobiasMDStahlKlausMDPavlos”“AgiosAslanidisTheodorosMD, PhDKorsosAnitaMDBabikBarnaMD, PhDNikandishRezaMDRezoagliEmanueleMD, PhDGiacominiMatteoMDNovaAliceMDFogagnoloAlbertoMDSpadaroSavinoMD, PhDCerianiRobertoMDMurroneMartinaMDWuMaddalena A.MDCogliatiChiaraMDColomboRiccardoMDCatenaEmanueleMDTurriniFabrizioMD, MScSimoniniMaria SoleMDFabbriSilviaMDPotalivoAntonellaMDFacondiniFrancescaMDGangitanoGianfilippoMDPerinTizianaMDGrazia BocciMariaMDAntonelliMassimoMDGommersDiederikMD, PhDRodríguez-GarcíaRaquelMDGámez-ZapataJorgeMDTaboada-FragaXianaMDCastroPedroMDTellezAdrianMDLander-AzconaArantxaMDEscós-OrtaJesúsMDMartín-DelgadoMaria C.MDAlgaba-CalderonAngelaMDFranch-LlasatDiegoMDRoche-CampoFerranMD, PhDLozano-GómezHerminiaMDZalba-EtayoBegoñaMD, PhDMichotMarc P.MDKlarerAlexanderEnsnerRolfMDSchottPeterMDUrechSeverinMDZellwegerNuriaMerkiLukasMDLambertAdrianaMDLaubeMarcusMDJeitzinerMarie M.RN, PhDJenni-MoserBeatriceRN, MScWiegandJanMDYuenBerndMDLienhardt-NobbeBarbaraWestphalenAndreaMDSalomonPetraMDDrvaricIrisMDHillgaertnerFrankMDSieberMarianneDullenkopfAlexanderMDPetersenLinaMDChauIvanMDKsouriHatemMD, PhDSridharanGovind OliverMDCereghettiSaraMDBoroliFilippoMDPuginJeromeMD, PhDGrazioliSergeMDRimensbergerPeter C.MDBürkleChristianMDMarrelJulienMDBrenniMirkoMDFleischIsabelleMDLavanchyJeromeMDPerezMarie-HeleneMDRameletAnne-SylvieMDWeberAnja BaltussenMDGereckePeterMDChristAndreasMDCerutiSamueleMDGlottaAndreaMDMarquardtKatharinaMDShaikhKarimMDHübnerTobiasMDNeffThomasMDRedeckerHermannMDMoret-BochatayMalloryMDBentrupFriederikeMeyer zuMD, MBAStudhalterMichaelMDStephanMichaelMDBremJanMDGehringNadineMDSelzDanielaMDNaonDidierMDKlegerGian-RetoMDPietschUrsMDFilipovicMiodragMDRisticAnetteMDSepulcriMichaelMDHeiseAntjeMDFranchitti LaurentMarileneMDLaurentJean-ChristopheMDWendel GarciaPedro D.MScSchuepbachRetoMDHeubergerDorotheaPhDBühlerPhilippMDBruggerSilvioMD, PhDFodorPatriciaMDLocherPascalMDCamenGiovanniMDGaspertTomislavMDJovicMarijaMDHaberthuerChristophMDLussmanRoger F.MDColakElifMD
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