Machine learning-driven in-hospital mortality prediction in HIV/AIDS patients with Cytomegalovirus infection: a single-centred retrospective study

( ) is a widely disseminated betaherpesvirus that typically induces latant infections. In immunocompromised populations, especially transplant and HIV-infected patients, infection increases in-hospital mortality. Although machine learning models have been widely used in clinical diagnosis and progno...

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Veröffentlicht in:Journal of medical microbiology 2024-11, Vol.73 (11)
Hauptverfasser: Lai, Shiyi, Wei, Wudi, Yang, Shixiong, Wu, Yuting, Shi, Minjuan, Meng, Sirun, Tao, Xing, Chen, Shanshan, Chen, Rongfeng, Su, Jinming, Yuan, Zongxiang, Ye, Li, Liang, Hao, Xie, Zhiman, Jiang, Junjun
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container_issue 11
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container_title Journal of medical microbiology
container_volume 73
creator Lai, Shiyi
Wei, Wudi
Yang, Shixiong
Wu, Yuting
Shi, Minjuan
Meng, Sirun
Tao, Xing
Chen, Shanshan
Chen, Rongfeng
Su, Jinming
Yuan, Zongxiang
Ye, Li
Liang, Hao
Xie, Zhiman
Jiang, Junjun
description ( ) is a widely disseminated betaherpesvirus that typically induces latant infections. In immunocompromised populations, especially transplant and HIV-infected patients, infection increases in-hospital mortality. Although machine learning models have been widely used in clinical diagnosis and prognosis prediction, reports on machine learning model predictions for the in-hospital mortality of HIV/AIDS patients with infection have not been reported. Analyze the general gemographic and clinical characteristics of HIV/AIDS patients with infection and identify the factors affecting the prognosis of this population, which will help to reduce their in-hospital mortality. Hospitalized HIV/AIDS patients with infection were recruited from the Fourth People's Hospital of Nanning, Guangxi, from 2012 to 2019. After dividing them into survival and death groups based on their in-hospital survival status, their general and clinical profiles were described. Following 1 : 3 propensity score matching to equalize baseline characteristics, three machine-learning models (Random Forest, Support Vector Machine and eXtreme Gradient Boosting) were deployed to forecast factors influencing prognosis. The SHapley Additive exPlanations tool explained the models. A total of 1102 HIV/AIDS patients with infection were analysed. There was no statistical difference in the general condition of the study subjects ( >0.05). Prevalent complications/coinfections included pneumonia (63.6%), (47.2%) and oral fungal infections (44.6%). There were significant differences between the groups in pneumonia, and hypoproteinaemia (
doi_str_mv 10.1099/jmm.0.001935
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In immunocompromised populations, especially transplant and HIV-infected patients, infection increases in-hospital mortality. Although machine learning models have been widely used in clinical diagnosis and prognosis prediction, reports on machine learning model predictions for the in-hospital mortality of HIV/AIDS patients with infection have not been reported. Analyze the general gemographic and clinical characteristics of HIV/AIDS patients with infection and identify the factors affecting the prognosis of this population, which will help to reduce their in-hospital mortality. Hospitalized HIV/AIDS patients with infection were recruited from the Fourth People's Hospital of Nanning, Guangxi, from 2012 to 2019. After dividing them into survival and death groups based on their in-hospital survival status, their general and clinical profiles were described. Following 1 : 3 propensity score matching to equalize baseline characteristics, three machine-learning models (Random Forest, Support Vector Machine and eXtreme Gradient Boosting) were deployed to forecast factors influencing prognosis. The SHapley Additive exPlanations tool explained the models. A total of 1102 HIV/AIDS patients with infection were analysed. There was no statistical difference in the general condition of the study subjects ( >0.05). Prevalent complications/coinfections included pneumonia (63.6%), (47.2%) and oral fungal infections (44.6%). There were significant differences between the groups in pneumonia, and hypoproteinaemia ( &lt;0.05). The differences in laboratory indicators between patients were also statistically significant ( &lt;0.05). The three machine learning models demonstrated good performance, identifying primary predictors of mortality. Pneumonia, urea, indirect bilirubin and platelet distribution width exhibited positive associations with death, with higher levels correlating with an increased mortality risk. Conversely, CD4 T-cell count, CD8 T-cell count and platelet displayed negative correlations with mortality. HIV/AIDS patients with CMV infection exhibit distinctive clinical features impacting survival outcomes. 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In immunocompromised populations, especially transplant and HIV-infected patients, infection increases in-hospital mortality. Although machine learning models have been widely used in clinical diagnosis and prognosis prediction, reports on machine learning model predictions for the in-hospital mortality of HIV/AIDS patients with infection have not been reported. Analyze the general gemographic and clinical characteristics of HIV/AIDS patients with infection and identify the factors affecting the prognosis of this population, which will help to reduce their in-hospital mortality. Hospitalized HIV/AIDS patients with infection were recruited from the Fourth People's Hospital of Nanning, Guangxi, from 2012 to 2019. After dividing them into survival and death groups based on their in-hospital survival status, their general and clinical profiles were described. Following 1 : 3 propensity score matching to equalize baseline characteristics, three machine-learning models (Random Forest, Support Vector Machine and eXtreme Gradient Boosting) were deployed to forecast factors influencing prognosis. The SHapley Additive exPlanations tool explained the models. A total of 1102 HIV/AIDS patients with infection were analysed. There was no statistical difference in the general condition of the study subjects ( >0.05). Prevalent complications/coinfections included pneumonia (63.6%), (47.2%) and oral fungal infections (44.6%). There were significant differences between the groups in pneumonia, and hypoproteinaemia ( &lt;0.05). The differences in laboratory indicators between patients were also statistically significant ( &lt;0.05). The three machine learning models demonstrated good performance, identifying primary predictors of mortality. Pneumonia, urea, indirect bilirubin and platelet distribution width exhibited positive associations with death, with higher levels correlating with an increased mortality risk. Conversely, CD4 T-cell count, CD8 T-cell count and platelet displayed negative correlations with mortality. HIV/AIDS patients with CMV infection exhibit distinctive clinical features impacting survival outcomes. 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In immunocompromised populations, especially transplant and HIV-infected patients, infection increases in-hospital mortality. Although machine learning models have been widely used in clinical diagnosis and prognosis prediction, reports on machine learning model predictions for the in-hospital mortality of HIV/AIDS patients with infection have not been reported. Analyze the general gemographic and clinical characteristics of HIV/AIDS patients with infection and identify the factors affecting the prognosis of this population, which will help to reduce their in-hospital mortality. Hospitalized HIV/AIDS patients with infection were recruited from the Fourth People's Hospital of Nanning, Guangxi, from 2012 to 2019. After dividing them into survival and death groups based on their in-hospital survival status, their general and clinical profiles were described. Following 1 : 3 propensity score matching to equalize baseline characteristics, three machine-learning models (Random Forest, Support Vector Machine and eXtreme Gradient Boosting) were deployed to forecast factors influencing prognosis. The SHapley Additive exPlanations tool explained the models. A total of 1102 HIV/AIDS patients with infection were analysed. There was no statistical difference in the general condition of the study subjects ( >0.05). Prevalent complications/coinfections included pneumonia (63.6%), (47.2%) and oral fungal infections (44.6%). There were significant differences between the groups in pneumonia, and hypoproteinaemia ( &lt;0.05). The differences in laboratory indicators between patients were also statistically significant ( &lt;0.05). The three machine learning models demonstrated good performance, identifying primary predictors of mortality. Pneumonia, urea, indirect bilirubin and platelet distribution width exhibited positive associations with death, with higher levels correlating with an increased mortality risk. Conversely, CD4 T-cell count, CD8 T-cell count and platelet displayed negative correlations with mortality. HIV/AIDS patients with CMV infection exhibit distinctive clinical features impacting survival outcomes. Machine learning models accurately identify key influencing factors and predict mortality risk in this population, which appears to be essential to reducing in-hospital mortality.</abstract><cop>England</cop><pmid>39606806</pmid><doi>10.1099/jmm.0.001935</doi></addata></record>
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subjects Acquired Immunodeficiency Syndrome - complications
Acquired Immunodeficiency Syndrome - mortality
Adult
China - epidemiology
Cytomegalovirus
Cytomegalovirus Infections - complications
Cytomegalovirus Infections - mortality
Female
HIV Infections - complications
HIV Infections - mortality
Hospital Mortality
Humans
Machine Learning
Male
Middle Aged
Prognosis
Retrospective Studies
title Machine learning-driven in-hospital mortality prediction in HIV/AIDS patients with Cytomegalovirus infection: a single-centred retrospective study
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