TY  - JOUR
AU  - Ma, Mengqing
AU  - Chen, Caimei
AU  - Chen, Dawei
AU  - Zhang, Hao
AU  - Du, Xia
AU  - Sun, Qing
AU  - Fan, Li
AU  - Kong, Huiping
AU  - Chen, Xueting
AU  - Cao, Changchun
AU  - Wan, Xin
PY  - 2024
DA  - 2024/12/19
TI  - A Machine Learning–Based Prediction Model for Acute Kidney Injury in Patients With Community-Acquired Pneumonia: Multicenter Validation Study
JO  - J Med Internet Res
SP  - e51255
VL  - 26
KW  - acute kidney injury
KW  - community-acquired
KW  - pneumonia
KW  - machine learning
KW  - prediction model
AB  - Background: Acute kidney injury (AKI) is common in patients with community-acquired pneumonia (CAP) and is associated with increased morbidity and mortality. Objective: This study aimed to establish and validate predictive models for AKI in hospitalized patients with CAP based on machine learning algorithms. Methods: We trained and externally validated 5 machine learning algorithms, including logistic regression, support vector machine, random forest, extreme gradient boosting, and deep forest (DF). Feature selection was conducted using the sliding window forward feature selection technique. Shapley additive explanations and local interpretable model-agnostic explanation techniques were applied to the optimal model for visual interpretation. Results: A total of 6371 patients with CAP met the inclusion criteria. The development of CAP-associated AKI (CAP-AKI) was recognized in 1006 (15.8%) patients. The 11 selected indicators were sex, temperature, breathing rate, diastolic blood pressure, C-reactive protein, albumin, white blood cell, hemoglobin, platelet, blood urea nitrogen, and neutrophil count. The DF model achieved the best area under the receiver operating characteristic curve (AUC) and accuracy in the internal (AUC=0.89, accuracy=0.90) and external validation sets (AUC=0.87, accuracy=0.83). Furthermore, the DF model had the best calibration among all models. In addition, a web-based prediction platform was developed to predict CAP-AKI. Conclusions: The model described in this study is the first multicenter-validated AKI prediction model that accurately predicts CAP-AKI during hospitalization. The web-based prediction platform embedded with the DF model serves as a user-friendly tool for early identification of high-risk patients. 
SN  - 1438-8871
UR  - https://www.jmir.org/2024/1/e51255
UR  - https://doi.org/10.2196/51255
UR  - http://www.ncbi.nlm.nih.gov/pubmed/39699941
DO  - 10.2196/51255
ID  - info:doi/10.2196/51255
ER  -