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    標題: Development of real-time individualized risk prediction models for contrast associated acute kidney injury and 30-day dialysis after contrast enhanced computed tomography
    作者: Chen, Yen-Yu
    Liu, Chung-Feng
    Shen, Yu-Ting
    Kuo, Yu-Ting
    Ko, Ching-Chung
    Chen, Tai-Yuan
    Wu, Te-Chang
    Shih, Yun-Ju
    貢獻者: Chi Mei Med Ctr, Dept Med Imaging
    Chi Mei Med Ctr, Dept Med Res
    Kaohsiung Med Univ, Coll Med, Dept Med
    Natl Sun Yat Sen Univ, Inst Precis Med, Coll Med
    Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
    Chang Jung Christian Univ, Grad Inst Med Sci
    Chang Jung Christian Univ, Dept Med Sci Ind
    Chang Jung Christian Univ, Dept Nursing
    關鍵字: Contrast-associated acute kidney injury
    Contrast-enhanced computed tomography
    Dialysis
    Risk prediction
    Artificial intelligence
    Machine learning
    日期: 2023
    上傳時間: 2024-12-25 11:04:25 (UTC+8)
    出版者: ELSEVIER IRELAND LTD
    摘要: Purpose: This study aimed to develop preprocedural real-time artificial intelligence (AI)-based systems for predicting individualized risks of contrast-associated acute kidney injury (CA-AKI) and dialysis requirement within 30 days following contrast-enhanced computed tomography (CECT).Method: This single-center, retrospective study analyzed adult patients from emergency or in-patient departments who underwent CECT; 18,895 patients were included after excluding those who were already on dialysis, had stage V chronic kidney disease, or had missing data regarding serum creatinine levels within 7 days before and after CECT. Clinical parameters, laboratory data, medication exposure, and comorbid diseases were selected as predictive features. The patients were randomly divided into model training and testing groups at a 7:3 ratio. Logistic regression (LR) and random forest (RF) were employed to create prediction models, which were evaluated using receiver operating characteristic curves.Results: The incidence rates of CA-AKI and dialysis within 30 days post-CECT were 6.69% and 0.98%, respectively. For CA-AKI prediction, LR and RF exhibited similar performance, with areas under curve (AUCs) of 0.769 and 0.757, respectively. For 30-day dialysis prediction, LR (AUC, 0.863) and RF (AUC, 0.872) also exhibited similar performance. Relative to eGFR-alone, the LR and RF models produced significantly higher AUCs for CAAKI prediction (LR vs. eGFR alone, 0.769 vs. 0.626, p < 0.001) and 30-day dialysis prediction (RF vs. eGFR alone, 0.872 vs. 0.738, p < 0.001).Conclusions: The proposed AI prediction models significantly outperformed eGFR-alone for predicting the CA-AKI and 30-day dialysis risks of emergency department and hospitalized patients who underwent CECT.
    關聯: European Journal of Radiology, v.167, Article 111034
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