Significance of platelets in the early warning of new-onset AKI in the ICU by using supervise learning: a retrospective analysis

Abstract

Objective

To explore a machine learning model for the early prediction of acute kidney injury (AKI) and to screen the related factors affecting new-onset AKI in the ICU.

Methods

A retrospective analysis was performed used the MIMIC-III data source. New onset of AKI defined based on the serum creatinine changed. We included 19 variables for AKI assessment using four machine learning models: support vector machines, logistic regression, and random forest. and XGBoost, using accuracy, specificity, precision, recall, F1 score, and AUROC (area under the ROC curve) to evaluate model performance. The four models predicted new-onset AKI 3–6–9–12 h ahead. The SHapley Additive exPlanation (SHAP) value is used to evaluate the feature importance of the model.

Results

We finally respectively extracted 1130 AKI patients and non-AKI patients from the MIMIC-III database. With the extension of the early warning time, the prediction performance of each model showed a downward trend, but the relative performance was consistent. The prediction performance comparison of the four models showed that the XGBoost model performed the best in all evaluation indicators in all the time point at new-onset AKI 3–6–9–12 h ahead (accuracy 0.809 vs 0.78 vs 0.744 vs 0.741, specificity 0.856 vs 0.826 vs 0.797 vs 0.787, precision 0.842 vs 0.81 vs 0.775 vs 0.766, recall 0.759 vs 0.734 vs 0.692 vs 0.694, Fl score 0.799 vs 0.769 vs 0.731 vs 0.729, AUROC 0.892 vs 0.857 vs 0.827 vs 0.818). In the prediction of AKI 6, 9 and 12 h ahead, the importance of creatinine, platelets, and height was the most important based on SHapley.

Conclusions

The machine learning model described in this study can predict AKI 3–6–9–12 h before the new-onset of AKI in ICU. In particular, platelet plays an important role.

Key message

• The new-onset of AKI in ICU is a common and important problem, which early be identified the risk of AKI can improve patients’ outcomes.

• We explored MIMIC-III and determined the exact time point of occurrence of AKI as the basis for the new-onset of AKI in ICU.

• XGBoost model performed the best prediction in all the time point at new-onset AKI 3–6–9–12 h ahead.

• For patients with the new-onset of AKI in ICU, platelets become an important factor associated with AKI.

Keywords:

• Acute kidney injury
• critical care
• machine learning
• predictive model
• influencing factors
• platelet

Author contributions

Substantial contributions to the conception or design of the work: L Su; the acquisition, analysis, or interpretation of data for the work: Y Liu, F Xie, Z Duan, L Li, H Gu; Drafting the wrote: P Pan, L Su; Revising it critically for important intellectual content: X Lu; Final approval of the version to be published: L Su and X Lu.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets in this study are available from the corresponding author on reasonable request.

Additional information

Funding

This work was supported by the Military Logistics Research Independent Research Project 2023; Chinese PLA General Hospital Youth Independent Innovation Research Project (22QNFC146); the key project of the Eighth Medical Center of the People's Liberation Army General Hospital (2021ZD001); the young talent promotion project of Beijing Science and Technology Association (BYESS2022035); Beijing Nova Program from the Beijing Municipal Science and Technology Commission (Z201100006820126).