Comparison of two prediction models for mortality ofacute paraquat poisoning / 预防医学

ABSTRACT

Objective@#To compare the effects of Cox proportional hazard regression model (Cox model) and extreme gradient boosting model ( XGBoost model ) on the prediction of the mortality of acute paraquat poisoning (APP).@*Methods@#The APP cases admitted to Qingdao Eighth People's Hospital and Shandong Provincial Hospital from January 1st of 2018 to December 1st of 2020 was recruited and divided into a training group and a verification group by a random number table. The Cox model and XGBoost model were established to select the predictors for APP mortality. Receiver operating characteristic ( ROC ) curve was drawn to analyze the predictive power of the two models, and the calibration was evaluated using Hosmer-Lemeshow test.@*Results@#Totally 150 APP cases were recruited. There were 75 cases each in the training group and in the verification group, with 52 and 55 cases died respectively, accounting for 69.33% and 73.33%. The Cox model showed that paraquat intake, the time from taking poison to seeing a doctor, the time for the first perfusion, the time for the first vomiting, aspartate aminotransferase, alanine aminotransferase, serum creatinine, blood urea nitrogen, white blood cell, lactic acid, creatine kinase isoenzymes, glucose, serum calcium and serum potassium were the predictors of APP mortality ( all P<0.05 ). The XGboost model showed that the predictive power of the factors in a descending order were the time from taking poison to seeing a doctor, the time for the first vomiting, the time for the first perfusion, lactic acid, white blood cell, paraquat intake, serum creatinine, serum potassium, serum calcium, creatine kinase isoenzymes, glucose, aspartate aminotransferase, blood urea nitrogen and alanine aminotransferase. The area under curve ( AUC ) of the XGBoost model for predicting was 0.972, which was greater than 0.921 of the Cox model ( P<0.05 ). The predicted results of the Cox model and XGBoost model were consistent with the actual situation ( P>0.05 ). @*Conclusion@#The Cox model and XGBoost model are consistent in predicting the mortality of APP, but the latter is better.