Using Machine Learning to Predict Mortality for COVID-19 Patients on Day Zero in the ICU


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Using Machine Learning to Predict Mortality for COVID-19 Patients on Day Zero in the ICU
Jamshidi Elham, Asgary Amirhossein, Tavakoli Nader, Zali Alireza, Esmaily Hadi, Jamaldini Seyed Hamid, Daaee Amir, Babajani Amirhesam, Kashi Mohammad Ali Sendani, Jamshidi Masoud, Rahi Sahand Jamal, Mansouri Nahal
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Rationale Given the expanding number of COVID-19 cases and the potential for upcoming waves of infection, there is an urgent need for early prediction of the severity of the disease in intensive care unit (ICU) patients to optimize treatment strategies.Objectives Early prediction of mortality using machine learning based on typical laboratory results and clinical data registered on the day of ICU admission.Methods We studied retrospectively 263 COVID-19 ICU patients. To find parameters with the highest predictive values, Kolmogorov-Smirnov and Pearson chi-squared tests were used. Logistic regression and random forest (RF) algorithms were utilized to build classification models. The impact of each marker on the RF model predictions was studied by implementing the local interpretable model-agnostic explanation technique (LIME-SP).Results Among 66 documented parameters, 15 factors with the highest predictive values were identified as follows: gender, age, blood urea nitrogen (BUN), creatinine, international normalized ratio (INR), albumin, mean corpuscular volume, white blood cell count, segmented neutrophil count, lymphocyte count, red cell distribution width (RDW), and mean cell hemoglobin along with a history of neurological, cardiovascular, and respiratory disorders. Our RF model can predict patients outcomes with a sensitivity of 70% and a specificity of 75%.Conclusions The most decisive variables in our model were increased levels of BUN, lowered albumin levels, increased creatinine, INR, and RDW along with gender and age. Complete blood count parameters were also crucial for some patients. Considering the importance of early triage decisions, this model can be a useful tool in COVID-19 ICU decision-making.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThe authors received no financial support for the research, authorship, and/or publication of this article.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:The study was performed after approval by Iran University of Medical Sciences Ethics Committee (approval ID: IR.IUMS.REC.1399.595)All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesThe data that support the findings of this study are available from the corresponding authors upon request.ACE2Angiotensin-Converting Enzyme 2AIArtificial IntelligenceBUNBlood Urea NitrogenCOVID-19coronavirus disease of 2019CICclinical impact curveCrCreatinineCRPC reactive proteinDCdecision curveICUIntensive care unitINRInternational Normalized RatioIFNinterferonIL-6Interleukin 6IQRinterquartile rangeKSKolmogorov-SmirnovLRLogistics regressionLIMElocal interpretable model-agnostic explanationLIME-SPlocal interpretable model-agnostic explanation submodular-pickMLMachine learningMCHmean corpuscular hemoglobinMCVmean corpuscular volumeRFRandom forestRDWRed blood cell distribution widthROCreceiver operating characteristic curveRT-PCRreverse transcription-polymerase chain reactionWBCwhite blood cells count
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24/06/2021 10:16
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07/07/2021 6:37
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