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Development and validation of a model for the early prediction of the RRT requirement in patients with rhabdomyolysis.

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机构: [1]Medical School of Chinese PLA, 28 Fuxing Road, Beijing, China [2]Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, 28 Fuxing Road, Beijing, China [3]Beijing Xiaomi Mobile Software Co., Ltd., China [4]Department of Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China [5]Department of Anesthesiology, The 920 Hospital of Joint Logistic Support Force of Chinese PLA, 650032 Kunming, Yunnan, China. [6]Medical Big Data Research Center, Chinese PLA General Hospital, Beijing, China. [7]School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China.
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Rhabdomyolysis (RM) is a complex set of clinical syndromes involving the rapid dissolution of skeletal muscles. The early detection of patients who need renal replacement therapy (RRT) is very important and may aid in delivering proper care and optimizing the use of limited resources. Retrospective analyses of the following three databases were performed: the eICU Collaborative Research Database (eICU-CRD), the Medical Information Mart for Intensive Care III (MIMIC-III) database and electronic medical records from the First Medical Centre of the Chinese People's Liberation Army General Hospital (PLAGH). The data from the eICU-CRD and MIMIC-III datasets were merged to form the derivation cohort. The data collected from the Chinese PLAGH were used for external validation. The factors predictive of the need for RRT were selected using a LASSO regression analysis. A logistic regression was selected as the algorithm. The model was built in Python using the ML library scikit-learn. The accuracy of the model was measured by the area under the receiver operating characteristic curve (AUC). R software was used for the LASSO regression analysis, nomogram, concordance index, calibration, and decision and clinical impact curves. In total, 1259 patients with RM (614 patients from eICU-CRD, 324 patients from the MIMIC-III database and 321 patients from the Chinese PLAGH) were eligible for this analysis. The rate of RRT was 15.0% (92/614) in the eICU-CRD database, 17.6% (57/324) in the MIMIC-III database and 5.6% in the Chinese PLAGH (18/321). After the LASSO regression selection, eight variables were included in the RRT prediction model. The AUC of the model in the training dataset was 0.818 (95% CI 0.78-0.87), the AUC in the test dataset was 0.794 (95% CI 0.72-0.86), and the AUC in the Chinese PLAGH dataset (external validation dataset) was 0.820 (95% CI 0.70-0.86). We developed and validated a model for the early prediction of the RRT requirement among patients with RM based on 8 variables commonly measured during the first 24 h after admission. Predicting the need for RRT could help ensure appropriate treatment and facilitate the optimization of the use of medical resources. Copyright © 2021 Elsevier Inc. All rights reserved.

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出版当年[2021]版:
大类 | 4 区 医学
小类 | 3 区 急救医学
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 急救医学
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第一作者机构: [1]Medical School of Chinese PLA, 28 Fuxing Road, Beijing, China [2]Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, 28 Fuxing Road, Beijing, China
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