Journal article
Derivation and Validation of a Machine Learning Algorithm for Predicting Venous Thromboembolism in Injured Children
Journal of pediatric surgery, v 58(6), pp 1200-1205
Jun 2023
PMID: 36925399
Abstract
Venous thromboembolism (VTE) causes significant morbidity in pediatric trauma patients. We applied machine learning algorithms to the Trauma Quality Improvement Program (TQIP) database to develop and validate a risk prediction model for VTE in injured children.
Patients ≤18 years were identified from TQIP (2017-2019, n = 383,814). Those administered VTE prophylaxis ≤24 h and missing the outcome (VTE) were removed (n = 347,576). Feature selection identified 15 predictors: intubation, need for supplemental oxygen, spinal injury, pelvic fractures, multiple long bone fractures, major surgery (neurosurgery, thoracic, orthopedic, vascular), age, transfusion requirement, intracranial pressure monitor or external ventricular drain placement, and low Glasgow Coma Scale score. Data was split into training (n = 251,409) and testing (n = 118,175) subsets. Machine learning algorithms were trained, tested, and compared.
Low-risk prediction: For the testing subset, all models outperformed the baseline rate of VTE (0.15%) with a predicted rate of 0.01-0.02% (p < 2.2e
). 88.4-89.4% of patients were classified as low risk by the models.
All models outperformed baseline with a predicted rate of VTE ranging from 1.13 to 1.32% (p < 2.2e
). The performance of the 3 models was not significantly different.
We developed a predictive model that differentiates injured children for development of VTE with high discrimination and can guide prophylaxis use.
Prognostic, Level II.
Retrospective, Cross-sectional.
Metrics
9 Record Views
2 citations in Scopus
Details
- Title
- Derivation and Validation of a Machine Learning Algorithm for Predicting Venous Thromboembolism in Injured Children
- Creators
- Stephanie C Papillon - St. Christopher's Hospital for ChildrenChristopher P Pennell - St. Christopher's Hospital for ChildrenSahal A Master - St. Christopher's Hospital for ChildrenEvan M Turner - Drexel UniversityL Grier Arthur - St. Christopher's Hospital for ChildrenHarsh Grewal - Drexel UniversityStephen C Aronoff - Temple University
- Publication Details
- Journal of pediatric surgery, v 58(6), pp 1200-1205
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics; Surgery
- Scopus ID
- 2-s2.0-85150780551
- Other Identifier
- 991021931093404721