Machine learning in the prediction of massive transfusion in trauma: a retrospective analysis as a proof-of-concept.

Purpose: Early administration and protocolization of massive hemorrhage protocols (MHP) has been associated with decreases in mortality, multiorgan system failure, and number of blood products used. Various prediction tools have been developed for the initiation of MHP, but no single tool has demons...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 50; no. 3; pp. 1073 - 1082
Autores principales: Nikouline, Anton, Feng, Jinyue, Rudzicz, Frank, Nathens, Avery, Nolan, Brodie
Formato: research tables/charts Journal Article
Publicado: Springer Nature Jun2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2024
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00068-023-02423-5
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        atl: Machine learning in the prediction of massive transfusion in trauma: a retrospective analysis as a proof-of-concept.
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          Nikouline, Anton
          Feng, Jinyue
          Rudzicz, Frank
          Nathens, Avery
          Nolan, Brodie
        affil: https://ror.org/037tz0e16 Department of Emergency Medicine, London Health Sciences Centre, 800 Commissioners Road E, N6A 5W9, London, ON, Canada
      sug:
        subj:
          Trauma Therapy
          Blood Transfusion
          Machine Learning
          Prediction Models
          Human
          Descriptive Statistics
          Data Analysis Software
          Funding Source
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          Female
          Adult
          Middle Age
          Emergency Medical Services
          Algorithms
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Purpose: Early administration and protocolization of massive hemorrhage protocols (MHP) has been associated with decreases in mortality, multiorgan system failure, and number of blood products used. Various prediction tools have been developed for the initiation of MHP, but no single tool has demonstrated strong prediction with early clinical data. We sought to develop a massive transfusion prediction model using machine learning and early clinical data. Methods: Using the National Trauma Data Bank from 2013 to 2018, we included severely injured trauma patients and extracted clinical features available from the pre-hospital and emergency department. We subsequently balanced our dataset and used the Boruta algorithm to determine feature selection. Massive transfusion was defined as five units at 4 h and ten units at 24 h. Six machine learning models were trained on the balanced dataset and tested on the original. Results: A total of 326,758 patients met our inclusion with 18,871 (5.8%) requiring massive transfusion. Emergency department models demonstrated strong performance characteristics with mean areas under the receiver-operating characteristic curve of 0.83. Extreme gradient boost modeling slightly outperformed and demonstrated adequate predictive performance with pre-hospital data only, as well as 4-h transfusion thresholds. Conclusions: We demonstrate the use of machine learning in developing an accurate prediction model for massive transfusion in trauma patients using early clinical data. This research demonstrates the potential utility of artificial intelligence as a clinical decision support tool.
      pubtype: Academic Journal
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        research
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      ougenre: Article
    language: English
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