Machine Learning Prediction of Death in Critically Ill Patients With Coronavirus Disease 2019

OBJECTIVES:. Critically ill patients with coronavirus disease 2019 have variable mortality. Risk scores could improve care and be used for prognostic enrichment in trials. We aimed to compare machine learning algorithms and develop a simple tool for predicting 28-day mortality in ICU patients with c...

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Autores principales:	Matthew M. Churpek, MD, MPH, PhD, Shruti Gupta, MD, MPH, Alexandra B. Spicer, MS, Salim S. Hayek, MD, Anand Srivastava, MD, MPH, Lili Chan, MD, MSCR, Michal L. Melamed, MD, MHS, Samantha K. Brenner, MD, MPH, Jared Radbel, MD, Farah Madhani-Lovely, MD, Pavan K. Bhatraju, MD, MSc, Anip Bansal, MD, Adam Green, MD, MBA, Nitender Goyal, MD, Shahzad Shaefi, MD, MPH, Chirag R. Parikh, MD, PhD, Matthew W. Semler, MD, David E. Leaf, MD, MMSc, for the STOP-COVID Investigators, Carol P. Walther, Samaya J. Anumudu, Justin Arunthamakun, Kathleen F. Kopecky, Gregory P. Milligan, Peter A. McCullough, ThuyDuyen Nguyen, Shahzad Shaefi, Megan L. Krajewski, Sidharth Shankar, Ameeka Pannu, Juan D. Valencia, Sushrut S. Waikar, Zoe A. Kibbelaar, Ambarish M. Athavale, Peter Hart, Oyintayo Ajiboye, Matthew Itteera, Adam Green, Jean-Sebastien Rachoin, Christa A. Schorr, Lisa Shea, Daniel L. Edmonston, Christopher L. Mosher, Alexandre M. Shehata, Zaza Cohen, Valerie Allusson, Gabriela Bambrick-Santoyo, Noor ul aain Bhatti, Bijal Metha, Aquino Williams, Samantha K. Brenner, Patricia Walters, Ronaldo C. Go, Keith M. Rose, Miguel A. Hernán, Amy M. Zhou, Ethan C. Kim, Rebecca Lisk, Lili Chan, Kusum S. Mathews, Steven G. Coca, Deena R. Altman, Aparna Saha, Howard Soh, Huei Hsun Wen, Sonali Bose, Emily Leven, Jing G. Wang, Gohar Mosoyan, Girish N. Nadkarni, Allon N. Friedman, John Guirguis, Rajat Kapoor, Christopher Meshberger, Chirag R. Parikh, Brian T. Garibaldi, Celia P. Corona-Villalobos, Yumeng Wen, Steven Menez, Rubab F. Malik, Carmen Elena Cervantes, Samir C. Gautam, Crystal Chang, H. Bryant Nguyen, Afshin Ahoubim, Leslie F. Thomas, Pramod K. Guru, Paul A. Bergl, Yan Zhou, Jesus Rodriguez, Jatan A. Shah, Mrigank S. Gupta, Princy N. Kumar, Deepa G. Lazarous, Seble G. Kassaye, Michal L. Melamed, Tanya S. Johns, Ryan Mocerino, Kalyan Prudhvi, Denzel Zhu, Rebecca V. Levy, Yorg Azzi, Molly Fisher, Milagros Yunes, Kaltrina Sedaliu, Ladan Golestaneh, Maureen Brogan, Jyotsana Thakkar, Neelja Kumar, Michael J. Ross, Michael Chang, Ritesh Raichoudhury, Edward J. Schenck, Soo Jung Cho, Maria Plataki, Sergio L. Alvarez-Mulett, Luis G. Gomez-Escobar, Di Pan, Stefi Lee, Jamuna Krishnan, William Whalen, David Charytan, Ashley Macina, Daniel W. Ross, Anand Srivastava, Alexander S. Leidner, Carlos Martinez, Jacqueline M. Kruser, Richard G. Wunderink, Alexander J. Hodakowski, Juan Carlos Q. Velez, Eboni G. Price-Haywood, Luis A. Matute-Trochez, Anna E. Hasty, Muner MB. Mohamed, Rupali S. Avasare, David Zonies, David E. Leaf, Shruti Gupta, Rebecca M. Baron, Meghan E. Sise, Erik T. Newman, Samah Abu Omar, Kapil K. Pokharel, Shreyak Sharma, Harkarandeep Singh, Simon Correa Gaviria, Tanveer Shaukat, Omer Kamal, Wei Wang, Heather Yang, Jeffery O. Boateng, Meghan Lee, Ian A. Strohbehn, Jiahua Li, Saif A. Muhsin, Ernest I. Mandel, Ariel L. Mueller, Nicholas S. Cairl, Farah Madhani-Lovely, Chris Rowan, Farah Madhai-Lovely, Vasil Peev, Jochen Reiser, John J. Byun, Andrew Vissing, Esha M. Kapania, Zoe Post, Nilam P. Patel, Joy-Marie Hermes, Anne K. Sutherland, Amee Patrawalla, Diana G. Finkel, Barbara A. Danek, Sowminya Arikapudi, Jeffrey M. Paer, Jared Radbel, Sonika Puri, Jag Sunderram, Matthew T. Scharf, Ayesha Ahmed, Ilya Berim, Jayanth Vatson, Shuchi Anand, Joseph E. Levitt, Pablo Garcia, Suzanne M. Boyle, Rui Song, Jingjing Zhang, Moh’d A. Sharshir, Vadym V. Rusnak, Anip Bansal, Amber S. Podoll, Michel Chonchol, Sunita Sharma, Ellen L. Burnham, Arash Rashidi, Rana Hejal, Eric Judd, Laura Latta, Ashita Tolwani, Timothy E. Albertson, Jason Y. Adams, Steven Y. Chang, Rebecca M. Beutler, Carl E. Schulze, Etienne Macedo, Harin Rhee, Kathleen D. Liu, Vasantha K. Jotwani, Jay L. Koyner, Chintan V. Shah, Vishal Jaikaransingh, Stephanie M. Toth-Manikowski, Min J. Joo, James P. Lash, Javier A. Neyra, Nourhan Chaaban, Alfredo Iardino, Elizabeth H. Au, Jill H. Sharma, Marie Anne Sosa, Sabrina Taldone, Gabriel Contreras, David De La Zerda, Hayley B. Gershengorn, Salim S. Hayek, Pennelope Blakely, Hanna Berlin, Tariq U. Azam, Husam Shadid, Michael Pan, Patrick O’ Hayer, Chelsea Meloche, Rafey Feroze, Kishan J. Padalia, Jeff Leya, John P. Donnelly, Andrew J. Admon, Jennifer E. Flythe, Matthew J. Tugman, Brent R. Brown, Amanda K. Leonberg-Yoo, Ryan C. Spiardi, Todd A. Miano, Meaghan S. Roche, Charles R. Vasquez, Amar D. Bansal, Natalie C. Ernecoff, Csaba P. Kovesdy, Miklos Z. Molnar, S. Susan Hedayati, Mridula V. Nadamuni, Sadaf S. Khan, Duwayne L. Willett, Samuel A.P. Short, Amanda D. Renaghan, Pavan Bhatraju, A. Bilal Malik, Matthew W. Semler, Anitha Vijayan, Christina Mariyam Joy, Tingting Li, Seth Goldberg, Patricia F. Kao, Greg L. Schumaker, Nitender Goyal, Anthony J. Faugno, Caroline M. Hsu, Asma Tariq, Leah Meyer, Marta Christov, Francis P. Wilson, Tanima Arora, Ugochukwu Ugwuowo
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/328399eedda5488b85fb3114093d9a34
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id	oai:doaj.org-article:328399eedda5488b85fb3114093d9a34
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Matthew M. Churpek, MD, MPH, PhD Shruti Gupta, MD, MPH Alexandra B. Spicer, MS Salim S. Hayek, MD Anand Srivastava, MD, MPH Lili Chan, MD, MSCR Michal L. Melamed, MD, MHS Samantha K. Brenner, MD, MPH Jared Radbel, MD Farah Madhani-Lovely, MD Pavan K. Bhatraju, MD, MSc Anip Bansal, MD Adam Green, MD, MBA Nitender Goyal, MD Shahzad Shaefi, MD, MPH Chirag R. Parikh, MD, PhD Matthew W. Semler, MD David E. Leaf, MD, MMSc for the STOP-COVID Investigators Carol P. Walther Samaya J. Anumudu Justin Arunthamakun Kathleen F. Kopecky Gregory P. Milligan Peter A. McCullough ThuyDuyen Nguyen Shahzad Shaefi Megan L. Krajewski Sidharth Shankar Ameeka Pannu Juan D. Valencia Sushrut S. Waikar Zoe A. Kibbelaar Ambarish M. Athavale Peter Hart Oyintayo Ajiboye Matthew Itteera Adam Green Jean-Sebastien Rachoin Christa A. Schorr Lisa Shea Daniel L. Edmonston Christopher L. Mosher Alexandre M. Shehata Zaza Cohen Valerie Allusson Gabriela Bambrick-Santoyo Noor ul aain Bhatti Bijal Metha Aquino Williams Samantha K. Brenner Patricia Walters Ronaldo C. Go Keith M. Rose Miguel A. Hernán Amy M. Zhou Ethan C. Kim Rebecca Lisk Lili Chan Kusum S. Mathews Steven G. Coca Deena R. Altman Aparna Saha Howard Soh Huei Hsun Wen Sonali Bose Emily Leven Jing G. Wang Gohar Mosoyan Girish N. Nadkarni Allon N. Friedman John Guirguis Rajat Kapoor Christopher Meshberger Chirag R. Parikh Brian T. Garibaldi Celia P. Corona-Villalobos Yumeng Wen Steven Menez Rubab F. Malik Carmen Elena Cervantes Samir C. Gautam Crystal Chang H. Bryant Nguyen Afshin Ahoubim Leslie F. Thomas Pramod K. Guru Paul A. Bergl Yan Zhou Jesus Rodriguez Jatan A. Shah Mrigank S. Gupta Princy N. Kumar Deepa G. Lazarous Seble G. Kassaye Michal L. Melamed Tanya S. Johns Ryan Mocerino Kalyan Prudhvi Denzel Zhu Rebecca V. Levy Yorg Azzi Molly Fisher Milagros Yunes Kaltrina Sedaliu Ladan Golestaneh Maureen Brogan Jyotsana Thakkar Neelja Kumar Michael J. Ross Michael Chang Ritesh Raichoudhury Edward J. Schenck Soo Jung Cho Maria Plataki Sergio L. Alvarez-Mulett Luis G. Gomez-Escobar Di Pan Stefi Lee Jamuna Krishnan William Whalen David Charytan Ashley Macina Daniel W. Ross Anand Srivastava Alexander S. Leidner Carlos Martinez Jacqueline M. Kruser Richard G. Wunderink Alexander J. Hodakowski Juan Carlos Q. Velez Eboni G. Price-Haywood Luis A. Matute-Trochez Anna E. Hasty Muner MB. Mohamed Rupali S. Avasare David Zonies David E. Leaf Shruti Gupta Rebecca M. Baron Meghan E. Sise Erik T. Newman Samah Abu Omar Kapil K. Pokharel Shreyak Sharma Harkarandeep Singh Simon Correa Gaviria Tanveer Shaukat Omer Kamal Wei Wang Heather Yang Jeffery O. Boateng Meghan Lee Ian A. Strohbehn Jiahua Li Saif A. Muhsin Ernest I. Mandel Ariel L. Mueller Nicholas S. Cairl Farah Madhani-Lovely Chris Rowan Farah Madhai-Lovely Vasil Peev Jochen Reiser John J. Byun Andrew Vissing Esha M. Kapania Zoe Post Nilam P. Patel Joy-Marie Hermes Anne K. Sutherland Amee Patrawalla Diana G. Finkel Barbara A. Danek Sowminya Arikapudi Jeffrey M. Paer Jared Radbel Sonika Puri Jag Sunderram Matthew T. Scharf Ayesha Ahmed Ilya Berim Jayanth Vatson Shuchi Anand Joseph E. Levitt Pablo Garcia Suzanne M. Boyle Rui Song Jingjing Zhang Moh’d A. Sharshir Vadym V. Rusnak Anip Bansal Amber S. Podoll Michel Chonchol Sunita Sharma Ellen L. Burnham Arash Rashidi Rana Hejal Eric Judd Laura Latta Ashita Tolwani Timothy E. Albertson Jason Y. Adams Steven Y. Chang Rebecca M. Beutler Carl E. Schulze Etienne Macedo Harin Rhee Kathleen D. Liu Vasantha K. Jotwani Jay L. Koyner Chintan V. Shah Vishal Jaikaransingh Stephanie M. Toth-Manikowski Min J. Joo James P. Lash Javier A. Neyra Nourhan Chaaban Alfredo Iardino Elizabeth H. Au Jill H. Sharma Marie Anne Sosa Sabrina Taldone Gabriel Contreras David De La Zerda Hayley B. Gershengorn Salim S. Hayek Pennelope Blakely Hanna Berlin Tariq U. Azam Husam Shadid Michael Pan Patrick O’ Hayer Chelsea Meloche Rafey Feroze Kishan J. Padalia Jeff Leya John P. Donnelly Andrew J. Admon Jennifer E. Flythe Matthew J. Tugman Brent R. Brown Amanda K. Leonberg-Yoo Ryan C. Spiardi Todd A. Miano Meaghan S. Roche Charles R. Vasquez Amar D. Bansal Natalie C. Ernecoff Csaba P. Kovesdy Miklos Z. Molnar S. Susan Hedayati Mridula V. Nadamuni Sadaf S. Khan Duwayne L. Willett Samuel A.P. Short Amanda D. Renaghan Pavan Bhatraju A. Bilal Malik Matthew W. Semler Anitha Vijayan Christina Mariyam Joy Tingting Li Seth Goldberg Patricia F. Kao Greg L. Schumaker Nitender Goyal Anthony J. Faugno Greg L. Schumaker Caroline M. Hsu Asma Tariq Leah Meyer Marta Christov Francis P. Wilson Tanima Arora Ugochukwu Ugwuowo Machine Learning Prediction of Death in Critically Ill Patients With Coronavirus Disease 2019
description	OBJECTIVES:. Critically ill patients with coronavirus disease 2019 have variable mortality. Risk scores could improve care and be used for prognostic enrichment in trials. We aimed to compare machine learning algorithms and develop a simple tool for predicting 28-day mortality in ICU patients with coronavirus disease 2019. DESIGN:. This was an observational study of adult patients with coronavirus disease 2019. The primary outcome was 28-day inhospital mortality. Machine learning models and a simple tool were derived using variables from the first 48 hours of ICU admission and validated externally in independent sites and temporally with more recent admissions. Models were compared with a modified Sequential Organ Failure Assessment score, National Early Warning Score, and CURB-65 using the area under the receiver operating characteristic curve and calibration. SETTING:. Sixty-eight U.S. ICUs. PATIENTS:. Adults with coronavirus disease 2019 admitted to 68 ICUs in the United States between March 4, 2020, and June 29, 2020. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. The study included 5,075 patients, 1,846 (36.4%) of whom died by day 28. eXtreme Gradient Boosting had the highest area under the receiver operating characteristic curve in external validation (0.81) and was well-calibrated, while k-nearest neighbors were the lowest performing machine learning algorithm (area under the receiver operating characteristic curve 0.69). Findings were similar with temporal validation. The simple tool, which was created using the most important features from the eXtreme Gradient Boosting model, had a significantly higher area under the receiver operating characteristic curve in external validation (0.78) than the Sequential Organ Failure Assessment score (0.69), National Early Warning Score (0.60), and CURB-65 (0.65; p < 0.05 for all comparisons). Age, number of ICU beds, creatinine, lactate, arterial pH, and Pao2/Fio2 ratio were the most important predictors in the eXtreme Gradient Boosting model. CONCLUSIONS:. eXtreme Gradient Boosting had the highest discrimination overall, and our simple tool had higher discrimination than a modified Sequential Organ Failure Assessment score, National Early Warning Score, and CURB-65 on external validation. These models could be used to improve triage decisions and clinical trial enrichment.
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author	Matthew M. Churpek, MD, MPH, PhD Shruti Gupta, MD, MPH Alexandra B. Spicer, MS Salim S. Hayek, MD Anand Srivastava, MD, MPH Lili Chan, MD, MSCR Michal L. Melamed, MD, MHS Samantha K. Brenner, MD, MPH Jared Radbel, MD Farah Madhani-Lovely, MD Pavan K. Bhatraju, MD, MSc Anip Bansal, MD Adam Green, MD, MBA Nitender Goyal, MD Shahzad Shaefi, MD, MPH Chirag R. Parikh, MD, PhD Matthew W. Semler, MD David E. Leaf, MD, MMSc for the STOP-COVID Investigators Carol P. Walther Samaya J. Anumudu Justin Arunthamakun Kathleen F. Kopecky Gregory P. Milligan Peter A. McCullough ThuyDuyen Nguyen Shahzad Shaefi Megan L. Krajewski Sidharth Shankar Ameeka Pannu Juan D. Valencia Sushrut S. Waikar Zoe A. Kibbelaar Ambarish M. Athavale Peter Hart Oyintayo Ajiboye Matthew Itteera Adam Green Jean-Sebastien Rachoin Christa A. Schorr Lisa Shea Daniel L. Edmonston Christopher L. Mosher Alexandre M. Shehata Zaza Cohen Valerie Allusson Gabriela Bambrick-Santoyo Noor ul aain Bhatti Bijal Metha Aquino Williams Samantha K. Brenner Patricia Walters Ronaldo C. Go Keith M. Rose Miguel A. Hernán Amy M. Zhou Ethan C. Kim Rebecca Lisk Lili Chan Kusum S. Mathews Steven G. Coca Deena R. Altman Aparna Saha Howard Soh Huei Hsun Wen Sonali Bose Emily Leven Jing G. Wang Gohar Mosoyan Girish N. Nadkarni Allon N. Friedman John Guirguis Rajat Kapoor Christopher Meshberger Chirag R. Parikh Brian T. Garibaldi Celia P. Corona-Villalobos Yumeng Wen Steven Menez Rubab F. Malik Carmen Elena Cervantes Samir C. Gautam Crystal Chang H. Bryant Nguyen Afshin Ahoubim Leslie F. Thomas Pramod K. Guru Paul A. Bergl Yan Zhou Jesus Rodriguez Jatan A. Shah Mrigank S. Gupta Princy N. Kumar Deepa G. Lazarous Seble G. Kassaye Michal L. Melamed Tanya S. Johns Ryan Mocerino Kalyan Prudhvi Denzel Zhu Rebecca V. Levy Yorg Azzi Molly Fisher Milagros Yunes Kaltrina Sedaliu Ladan Golestaneh Maureen Brogan Jyotsana Thakkar Neelja Kumar Michael J. Ross Michael Chang Ritesh Raichoudhury Edward J. Schenck Soo Jung Cho Maria Plataki Sergio L. Alvarez-Mulett Luis G. Gomez-Escobar Di Pan Stefi Lee Jamuna Krishnan William Whalen David Charytan Ashley Macina Daniel W. Ross Anand Srivastava Alexander S. Leidner Carlos Martinez Jacqueline M. Kruser Richard G. Wunderink Alexander J. Hodakowski Juan Carlos Q. Velez Eboni G. Price-Haywood Luis A. Matute-Trochez Anna E. Hasty Muner MB. Mohamed Rupali S. Avasare David Zonies David E. Leaf Shruti Gupta Rebecca M. Baron Meghan E. Sise Erik T. Newman Samah Abu Omar Kapil K. Pokharel Shreyak Sharma Harkarandeep Singh Simon Correa Gaviria Tanveer Shaukat Omer Kamal Wei Wang Heather Yang Jeffery O. Boateng Meghan Lee Ian A. Strohbehn Jiahua Li Saif A. Muhsin Ernest I. Mandel Ariel L. Mueller Nicholas S. Cairl Farah Madhani-Lovely Chris Rowan Farah Madhai-Lovely Vasil Peev Jochen Reiser John J. Byun Andrew Vissing Esha M. Kapania Zoe Post Nilam P. Patel Joy-Marie Hermes Anne K. Sutherland Amee Patrawalla Diana G. Finkel Barbara A. Danek Sowminya Arikapudi Jeffrey M. Paer Jared Radbel Sonika Puri Jag Sunderram Matthew T. Scharf Ayesha Ahmed Ilya Berim Jayanth Vatson Shuchi Anand Joseph E. Levitt Pablo Garcia Suzanne M. Boyle Rui Song Jingjing Zhang Moh’d A. Sharshir Vadym V. Rusnak Anip Bansal Amber S. Podoll Michel Chonchol Sunita Sharma Ellen L. Burnham Arash Rashidi Rana Hejal Eric Judd Laura Latta Ashita Tolwani Timothy E. Albertson Jason Y. Adams Steven Y. Chang Rebecca M. Beutler Carl E. Schulze Etienne Macedo Harin Rhee Kathleen D. Liu Vasantha K. Jotwani Jay L. Koyner Chintan V. Shah Vishal Jaikaransingh Stephanie M. Toth-Manikowski Min J. Joo James P. Lash Javier A. Neyra Nourhan Chaaban Alfredo Iardino Elizabeth H. Au Jill H. Sharma Marie Anne Sosa Sabrina Taldone Gabriel Contreras David De La Zerda Hayley B. Gershengorn Salim S. Hayek Pennelope Blakely Hanna Berlin Tariq U. Azam Husam Shadid Michael Pan Patrick O’ Hayer Chelsea Meloche Rafey Feroze Kishan J. Padalia Jeff Leya John P. Donnelly Andrew J. Admon Jennifer E. Flythe Matthew J. Tugman Brent R. Brown Amanda K. Leonberg-Yoo Ryan C. Spiardi Todd A. Miano Meaghan S. Roche Charles R. Vasquez Amar D. Bansal Natalie C. Ernecoff Csaba P. Kovesdy Miklos Z. Molnar S. Susan Hedayati Mridula V. Nadamuni Sadaf S. Khan Duwayne L. Willett Samuel A.P. Short Amanda D. Renaghan Pavan Bhatraju A. Bilal Malik Matthew W. Semler Anitha Vijayan Christina Mariyam Joy Tingting Li Seth Goldberg Patricia F. Kao Greg L. Schumaker Nitender Goyal Anthony J. Faugno Greg L. Schumaker Caroline M. Hsu Asma Tariq Leah Meyer Marta Christov Francis P. Wilson Tanima Arora Ugochukwu Ugwuowo
author_facet	Matthew M. Churpek, MD, MPH, PhD Shruti Gupta, MD, MPH Alexandra B. Spicer, MS Salim S. Hayek, MD Anand Srivastava, MD, MPH Lili Chan, MD, MSCR Michal L. Melamed, MD, MHS Samantha K. Brenner, MD, MPH Jared Radbel, MD Farah Madhani-Lovely, MD Pavan K. Bhatraju, MD, MSc Anip Bansal, MD Adam Green, MD, MBA Nitender Goyal, MD Shahzad Shaefi, MD, MPH Chirag R. Parikh, MD, PhD Matthew W. Semler, MD David E. Leaf, MD, MMSc for the STOP-COVID Investigators Carol P. Walther Samaya J. Anumudu Justin Arunthamakun Kathleen F. Kopecky Gregory P. Milligan Peter A. McCullough ThuyDuyen Nguyen Shahzad Shaefi Megan L. Krajewski Sidharth Shankar Ameeka Pannu Juan D. Valencia Sushrut S. Waikar Zoe A. Kibbelaar Ambarish M. Athavale Peter Hart Oyintayo Ajiboye Matthew Itteera Adam Green Jean-Sebastien Rachoin Christa A. Schorr Lisa Shea Daniel L. Edmonston Christopher L. Mosher Alexandre M. Shehata Zaza Cohen Valerie Allusson Gabriela Bambrick-Santoyo Noor ul aain Bhatti Bijal Metha Aquino Williams Samantha K. Brenner Patricia Walters Ronaldo C. Go Keith M. Rose Miguel A. Hernán Amy M. Zhou Ethan C. Kim Rebecca Lisk Lili Chan Kusum S. Mathews Steven G. Coca Deena R. Altman Aparna Saha Howard Soh Huei Hsun Wen Sonali Bose Emily Leven Jing G. Wang Gohar Mosoyan Girish N. Nadkarni Allon N. Friedman John Guirguis Rajat Kapoor Christopher Meshberger Chirag R. Parikh Brian T. Garibaldi Celia P. Corona-Villalobos Yumeng Wen Steven Menez Rubab F. Malik Carmen Elena Cervantes Samir C. Gautam Crystal Chang H. Bryant Nguyen Afshin Ahoubim Leslie F. Thomas Pramod K. Guru Paul A. Bergl Yan Zhou Jesus Rodriguez Jatan A. Shah Mrigank S. Gupta Princy N. Kumar Deepa G. Lazarous Seble G. Kassaye Michal L. Melamed Tanya S. Johns Ryan Mocerino Kalyan Prudhvi Denzel Zhu Rebecca V. Levy Yorg Azzi Molly Fisher Milagros Yunes Kaltrina Sedaliu Ladan Golestaneh Maureen Brogan Jyotsana Thakkar Neelja Kumar Michael J. Ross Michael Chang Ritesh Raichoudhury Edward J. Schenck Soo Jung Cho Maria Plataki Sergio L. Alvarez-Mulett Luis G. Gomez-Escobar Di Pan Stefi Lee Jamuna Krishnan William Whalen David Charytan Ashley Macina Daniel W. Ross Anand Srivastava Alexander S. Leidner Carlos Martinez Jacqueline M. Kruser Richard G. Wunderink Alexander J. Hodakowski Juan Carlos Q. Velez Eboni G. Price-Haywood Luis A. Matute-Trochez Anna E. Hasty Muner MB. Mohamed Rupali S. Avasare David Zonies David E. Leaf Shruti Gupta Rebecca M. Baron Meghan E. Sise Erik T. Newman Samah Abu Omar Kapil K. Pokharel Shreyak Sharma Harkarandeep Singh Simon Correa Gaviria Tanveer Shaukat Omer Kamal Wei Wang Heather Yang Jeffery O. Boateng Meghan Lee Ian A. Strohbehn Jiahua Li Saif A. Muhsin Ernest I. Mandel Ariel L. Mueller Nicholas S. Cairl Farah Madhani-Lovely Chris Rowan Farah Madhai-Lovely Vasil Peev Jochen Reiser John J. Byun Andrew Vissing Esha M. Kapania Zoe Post Nilam P. Patel Joy-Marie Hermes Anne K. Sutherland Amee Patrawalla Diana G. Finkel Barbara A. Danek Sowminya Arikapudi Jeffrey M. Paer Jared Radbel Sonika Puri Jag Sunderram Matthew T. Scharf Ayesha Ahmed Ilya Berim Jayanth Vatson Shuchi Anand Joseph E. Levitt Pablo Garcia Suzanne M. Boyle Rui Song Jingjing Zhang Moh’d A. Sharshir Vadym V. Rusnak Anip Bansal Amber S. Podoll Michel Chonchol Sunita Sharma Ellen L. Burnham Arash Rashidi Rana Hejal Eric Judd Laura Latta Ashita Tolwani Timothy E. Albertson Jason Y. Adams Steven Y. Chang Rebecca M. Beutler Carl E. Schulze Etienne Macedo Harin Rhee Kathleen D. Liu Vasantha K. Jotwani Jay L. Koyner Chintan V. Shah Vishal Jaikaransingh Stephanie M. Toth-Manikowski Min J. Joo James P. Lash Javier A. Neyra Nourhan Chaaban Alfredo Iardino Elizabeth H. Au Jill H. Sharma Marie Anne Sosa Sabrina Taldone Gabriel Contreras David De La Zerda Hayley B. Gershengorn Salim S. Hayek Pennelope Blakely Hanna Berlin Tariq U. Azam Husam Shadid Michael Pan Patrick O’ Hayer Chelsea Meloche Rafey Feroze Kishan J. Padalia Jeff Leya John P. Donnelly Andrew J. Admon Jennifer E. Flythe Matthew J. Tugman Brent R. Brown Amanda K. Leonberg-Yoo Ryan C. Spiardi Todd A. Miano Meaghan S. Roche Charles R. Vasquez Amar D. Bansal Natalie C. Ernecoff Csaba P. Kovesdy Miklos Z. Molnar S. Susan Hedayati Mridula V. Nadamuni Sadaf S. Khan Duwayne L. Willett Samuel A.P. Short Amanda D. Renaghan Pavan Bhatraju A. Bilal Malik Matthew W. Semler Anitha Vijayan Christina Mariyam Joy Tingting Li Seth Goldberg Patricia F. Kao Greg L. Schumaker Nitender Goyal Anthony J. Faugno Greg L. Schumaker Caroline M. Hsu Asma Tariq Leah Meyer Marta Christov Francis P. Wilson Tanima Arora Ugochukwu Ugwuowo
author_sort	Matthew M. Churpek, MD, MPH, PhD
title	Machine Learning Prediction of Death in Critically Ill Patients With Coronavirus Disease 2019
title_short	Machine Learning Prediction of Death in Critically Ill Patients With Coronavirus Disease 2019
title_full	Machine Learning Prediction of Death in Critically Ill Patients With Coronavirus Disease 2019
title_fullStr	Machine Learning Prediction of Death in Critically Ill Patients With Coronavirus Disease 2019
title_full_unstemmed	Machine Learning Prediction of Death in Critically Ill Patients With Coronavirus Disease 2019
title_sort	machine learning prediction of death in critically ill patients with coronavirus disease 2019
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/328399eedda5488b85fb3114093d9a34
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spelling	oai:doaj.org-article:328399eedda5488b85fb3114093d9a342021-11-25T07:55:46ZMachine Learning Prediction of Death in Critically Ill Patients With Coronavirus Disease 20192639-802810.1097/CCE.0000000000000515https://doaj.org/article/328399eedda5488b85fb3114093d9a342021-08-01T00:00:00Zhttp://journals.lww.com/10.1097/CCE.0000000000000515https://doaj.org/toc/2639-8028OBJECTIVES:. Critically ill patients with coronavirus disease 2019 have variable mortality. Risk scores could improve care and be used for prognostic enrichment in trials. We aimed to compare machine learning algorithms and develop a simple tool for predicting 28-day mortality in ICU patients with coronavirus disease 2019. DESIGN:. This was an observational study of adult patients with coronavirus disease 2019. The primary outcome was 28-day inhospital mortality. Machine learning models and a simple tool were derived using variables from the first 48 hours of ICU admission and validated externally in independent sites and temporally with more recent admissions. Models were compared with a modified Sequential Organ Failure Assessment score, National Early Warning Score, and CURB-65 using the area under the receiver operating characteristic curve and calibration. SETTING:. Sixty-eight U.S. ICUs. PATIENTS:. Adults with coronavirus disease 2019 admitted to 68 ICUs in the United States between March 4, 2020, and June 29, 2020. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. The study included 5,075 patients, 1,846 (36.4%) of whom died by day 28. eXtreme Gradient Boosting had the highest area under the receiver operating characteristic curve in external validation (0.81) and was well-calibrated, while k-nearest neighbors were the lowest performing machine learning algorithm (area under the receiver operating characteristic curve 0.69). Findings were similar with temporal validation. The simple tool, which was created using the most important features from the eXtreme Gradient Boosting model, had a significantly higher area under the receiver operating characteristic curve in external validation (0.78) than the Sequential Organ Failure Assessment score (0.69), National Early Warning Score (0.60), and CURB-65 (0.65; p < 0.05 for all comparisons). Age, number of ICU beds, creatinine, lactate, arterial pH, and Pao2/Fio2 ratio were the most important predictors in the eXtreme Gradient Boosting model. CONCLUSIONS:. eXtreme Gradient Boosting had the highest discrimination overall, and our simple tool had higher discrimination than a modified Sequential Organ Failure Assessment score, National Early Warning Score, and CURB-65 on external validation. These models could be used to improve triage decisions and clinical trial enrichment.Matthew M. Churpek, MD, MPH, PhDShruti Gupta, MD, MPHAlexandra B. Spicer, MSSalim S. Hayek, MDAnand Srivastava, MD, MPHLili Chan, MD, MSCRMichal L. Melamed, MD, MHSSamantha K. Brenner, MD, MPHJared Radbel, MDFarah Madhani-Lovely, MDPavan K. Bhatraju, MD, MScAnip Bansal, MDAdam Green, MD, MBANitender Goyal, MDShahzad Shaefi, MD, MPHChirag R. Parikh, MD, PhDMatthew W. Semler, MDDavid E. Leaf, MD, MMScfor the STOP-COVID InvestigatorsCarol P. WaltherSamaya J. AnumuduJustin ArunthamakunKathleen F. KopeckyGregory P. MilliganPeter A. McCulloughThuyDuyen NguyenShahzad ShaefiMegan L. KrajewskiSidharth ShankarAmeeka PannuJuan D. ValenciaSushrut S. WaikarZoe A. KibbelaarAmbarish M. AthavalePeter HartOyintayo AjiboyeMatthew ItteeraAdam GreenJean-Sebastien RachoinChrista A. SchorrLisa SheaDaniel L. EdmonstonChristopher L. MosherAlexandre M. ShehataZaza CohenValerie AllussonGabriela Bambrick-SantoyoNoor ul aain BhattiBijal MethaAquino WilliamsSamantha K. BrennerPatricia WaltersRonaldo C. GoKeith M. RoseMiguel A. HernánAmy M. ZhouEthan C. KimRebecca LiskLili ChanKusum S. MathewsSteven G. CocaDeena R. AltmanAparna SahaHoward SohHuei Hsun WenSonali BoseEmily LevenJing G. WangGohar MosoyanGirish N. NadkarniAllon N. FriedmanJohn GuirguisRajat KapoorChristopher MeshbergerChirag R. ParikhBrian T. GaribaldiCelia P. Corona-VillalobosYumeng WenSteven MenezRubab F. MalikCarmen Elena CervantesSamir C. GautamCrystal ChangH. Bryant NguyenAfshin AhoubimLeslie F. ThomasPramod K. GuruPaul A. BerglYan ZhouJesus RodriguezJatan A. ShahMrigank S. GuptaPrincy N. KumarDeepa G. LazarousSeble G. KassayeMichal L. MelamedTanya S. JohnsRyan MocerinoKalyan PrudhviDenzel ZhuRebecca V. LevyYorg AzziMolly FisherMilagros YunesKaltrina SedaliuLadan GolestanehMaureen BroganJyotsana ThakkarNeelja KumarMichael J. RossMichael ChangRitesh RaichoudhuryEdward J. SchenckSoo Jung ChoMaria PlatakiSergio L. Alvarez-MulettLuis G. Gomez-EscobarDi PanStefi LeeJamuna KrishnanWilliam WhalenDavid CharytanAshley MacinaDaniel W. RossAnand SrivastavaAlexander S. LeidnerCarlos MartinezJacqueline M. KruserRichard G. WunderinkAlexander J. HodakowskiJuan Carlos Q. VelezEboni G. Price-HaywoodLuis A. Matute-TrochezAnna E. HastyMuner MB. MohamedRupali S. AvasareDavid ZoniesDavid E. LeafShruti GuptaRebecca M. BaronMeghan E. SiseErik T. NewmanSamah Abu OmarKapil K. PokharelShreyak SharmaHarkarandeep SinghSimon Correa GaviriaTanveer ShaukatOmer KamalWei WangHeather YangJeffery O. BoatengMeghan LeeIan A. StrohbehnJiahua LiSaif A. MuhsinErnest I. MandelAriel L. MuellerNicholas S. CairlFarah Madhani-LovelyChris RowanFarah Madhai-LovelyVasil PeevJochen ReiserJohn J. ByunAndrew VissingEsha M. KapaniaZoe PostNilam P. PatelJoy-Marie HermesAnne K. SutherlandAmee PatrawallaDiana G. FinkelBarbara A. DanekSowminya ArikapudiJeffrey M. PaerJared RadbelSonika PuriJag SunderramMatthew T. ScharfAyesha AhmedIlya BerimJayanth VatsonShuchi AnandJoseph E. LevittPablo GarciaSuzanne M. BoyleRui SongJingjing ZhangMoh’d A. SharshirVadym V. RusnakAnip BansalAmber S. PodollMichel ChoncholSunita SharmaEllen L. BurnhamArash RashidiRana HejalEric JuddLaura LattaAshita TolwaniTimothy E. AlbertsonJason Y. AdamsSteven Y. ChangRebecca M. BeutlerCarl E. SchulzeEtienne MacedoHarin RheeKathleen D. LiuVasantha K. JotwaniJay L. KoynerChintan V. ShahVishal JaikaransinghStephanie M. Toth-ManikowskiMin J. JooJames P. LashJavier A. NeyraNourhan ChaabanAlfredo IardinoElizabeth H. AuJill H. SharmaMarie Anne SosaSabrina TaldoneGabriel ContrerasDavid De La ZerdaHayley B. GershengornSalim S. HayekPennelope BlakelyHanna BerlinTariq U. AzamHusam ShadidMichael PanPatrick O’ HayerChelsea MelocheRafey FerozeKishan J. PadaliaJeff LeyaJohn P. DonnellyAndrew J. AdmonJennifer E. FlytheMatthew J. TugmanBrent R. BrownAmanda K. Leonberg-YooRyan C. SpiardiTodd A. MianoMeaghan S. RocheCharles R. VasquezAmar D. BansalNatalie C. ErnecoffCsaba P. KovesdyMiklos Z. MolnarS. Susan HedayatiMridula V. NadamuniSadaf S. KhanDuwayne L. WillettSamuel A.P. ShortAmanda D. RenaghanPavan BhatrajuA. Bilal MalikMatthew W. SemlerAnitha VijayanChristina Mariyam JoyTingting LiSeth GoldbergPatricia F. KaoGreg L. SchumakerNitender GoyalAnthony J. FaugnoGreg L. SchumakerCaroline M. HsuAsma TariqLeah MeyerMarta ChristovFrancis P. WilsonTanima AroraUgochukwu UgwuowoWolters KluwerarticleMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care Explorations, Vol 3, Iss 8, p e0515 (2021)

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