Journal Article

Machine learning-based prognostic prediction for hospitalized HIV/AIDS patients with cryptococcus infection in Guangxi, China

Zhan, Baili, Xie, Zhiman, Yang, Shixiong, He, Xiaotao, Meng, Sirun, Xie, Xiaoting, Liang, Hao, Wei, Wudi, Bao, Xiuli, Zhang, Meng, Ye, Li, Jiang, Junjun

2024

Overview

Objective To develop and validate a machine learning model for predicting mortality-associated prognostic factors in order to reduce in-hospital mortality rates among HIV/AIDS patients with Cryptococcus infection in Guangxi, China. Methods This retrospective prognostic study included HIV/AIDS patients with cryptococcosis in the Fourth People’s Hospital of Nanning from October 2011 to June 2019. Clinical features were extracted and used to train ten machine learning models, including Logistic Regression, KNN, DT, RF, Adaboost, Xgboost, LightGBM, Catboost, SVM, and NBM, to predict the outcome of HIV patients with cryptococcosis infection. The sensitivity, specificity, AUC, and F1 value were applied to assess model performance in both the testing and training sets. The optimal model was selected and interpreted. Results A total of 396 patients were included in the study. The average in-hospital mortality of HIV/AIDS patients with cryptococcosis was 12.9% from 2012 to 2019. After feature screening, 20 clinical features were selected for model construction, accounting for 93.8%, including ART, Electrolyte disorder, Anemia, and 17 laboratory tests. The RF model (AUC 0.9787, Sensitivity 0.9535, Specificity 0.8889, F1 0.7455) and the SVM model (AUC 0.9286, Sensitivity 0.7907, Specificity 0.9786, F1 0.8293) had excellent performance. The SHAP analysis showed that the primary risk factors for prognosis prediction were identified as BUN/CREA, Electrolyte disorder, NEUT%, Urea, and IBIL. Conclusions RF and SVM machine learning models have shown promising predictive abilities for the prognosis of hospitalized HIV/AIDS patients with cryptococcosis, which can aid clinical assessment and treatment decisions for patient prognosis.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acquired immune deficiency syndrome / Acquired Immunodeficiency Syndrome - complications / Acquired Immunodeficiency Syndrome - mortality / Adult / AIDS / Algorithms / Anemia / Antiretroviral therapy / Artificial intelligence / Care and treatment / Chi-square test / China - epidemiology / Cryptococcal infections / Cryptococcosis / Cryptococcosis - diagnosis / Cryptococcosis - mortality / Cryptococcus / Disease / Fatalities / Female / Fungi / HIV / HIV Infections - complications / HIV Infections - mortality / HIV patients / Hospital Mortality / Hospital patients / Hospitalization / Hospitals / Human immunodeficiency virus / Humans / Infections / Infectious Diseases / Internal Medicine / Laboratories / Laboratory tests / Learning algorithms / Machine Learning / Male / Mann-Whitney U test / Medical Microbiology / Medical prognosis / Medical research / Medicine / Medicine & Public Health / Meningitis / Middle Aged / Mortality / Parasitology / Patients / Pneumonia / Prediction of prognosis / Predictions / Prognosis / Public health / Regression analysis / Retrospective Studies / Risk factors / Support vector machines / Tropical Medicine / Tuberculosis / Urea / Variables