Skip to main content
Top
Published in: BMC Emergency Medicine 1/2021

Open Access 01-12-2021 | Research

Predicting venous thromboembolism in hospitalized trauma patients: a combination of the Caprini score and data-driven machine learning model

Authors: Lingxiao He, Lei Luo, Xiaoling Hou, Dengbin Liao, Ran Liu, Chaowei Ouyang, Guanglin Wang

Published in: BMC Emergency Medicine | Issue 1/2021

Login to get access

Abstract

Background

Venous thromboembolism (VTE) is a common complication of hospitalized trauma patients and has an adverse impact on patient outcomes. However, there is still a lack of appropriate tools for effectively predicting VTE for trauma patients. We try to verify the accuracy of the Caprini score for predicting VTE in trauma patients, and further improve the prediction through machine learning algorithms.

Methods

We retrospectively reviewed emergency trauma patients who were admitted to a trauma center in a tertiary hospital from September 2019 to March 2020. The data in the patient’s electronic health record (EHR) and the Caprini score were extracted, combined with multiple feature screening methods and the random forest (RF) algorithm to constructs the VTE prediction model, and compares the prediction performance of (1) using only Caprini score; (2) using EHR data to build a machine learning model; (3) using EHR data and Caprini score to build a machine learning model. True Positive Rate (TPR), False Positive Rate (FPR), Area Under Curve (AUC), accuracy, and precision were reported.

Results

The Caprini score shows a good VTE prediction effect on the trauma hospitalized population when the cut-off point is 11 (TPR = 0.667, FPR = 0.227, AUC = 0.773), The best prediction model is LASSO+RF model combined with Caprini Score and other five features extracted from EHR data (TPR = 0.757, FPR = 0.290, AUC = 0.799).

Conclusion

The Caprini score has good VTE prediction performance in trauma patients, and the use of machine learning methods can further improve the prediction performance.
Appendix
Available only for authorised users
Literature
13.
go back to reference Caprini J, Arcelus J, Hasty J, Tamhane A, Fabrega F. Clinical assessment of venous thromboembolic risk in surgical patients. Semin Thromb Hemost. 1991;17(Suppl 3):304–12.PubMed Caprini J, Arcelus J, Hasty J, Tamhane A, Fabrega F. Clinical assessment of venous thromboembolic risk in surgical patients. Semin Thromb Hemost. 1991;17(Suppl 3):304–12.PubMed
15.
go back to reference Surgery CSo. Guidelines for prevention and Management of Perioperative Venous Thrombosis in general surgery in China. Chin J Surg. 2016;54(5):321–7. Surgery CSo. Guidelines for prevention and Management of Perioperative Venous Thrombosis in general surgery in China. Chin J Surg. 2016;54(5):321–7.
16.
go back to reference Lu Q, Zhang W, Wang X, Niu T, Zhong H, Liu C, et al. Guidelines for prevention of venous thromboembolism of hospitalized patients in Changhai hospital. Hosp Adm J Chin PLA. 2018;25(11):1032–7. Lu Q, Zhang W, Wang X, Niu T, Zhong H, Liu C, et al. Guidelines for prevention of venous thromboembolism of hospitalized patients in Changhai hospital. Hosp Adm J Chin PLA. 2018;25(11):1032–7.
18.
go back to reference Luksameearunothai K, Sa-Ngasoongsong P, Kulachote N, Thamyongkit S, Fuangfa P, Chanplakorn P, et al. Usefulness of clinical predictors for preoperative screening of deep vein thrombosis in hip fractures. BMC Musculoskelet Disord. 2017;18(1):208. https://doi.org/10.1186/s12891-017-1582-5. Luksameearunothai K, Sa-Ngasoongsong P, Kulachote N, Thamyongkit S, Fuangfa P, Chanplakorn P, et al. Usefulness of clinical predictors for preoperative screening of deep vein thrombosis in hip fractures. BMC Musculoskelet Disord. 2017;18(1):208. https://​doi.​org/​10.​1186/​s12891-017-1582-5.
23.
go back to reference Tibshirani R. Regression shrinkage and selection via the Lasso. J R Stat Soc B (Methodological). 1996;58(1):267–88.CrossRef Tibshirani R. Regression shrinkage and selection via the Lasso. J R Stat Soc B (Methodological). 1996;58(1):267–88.CrossRef
24.
go back to reference Le Cessie S, Van Houwelingen JC. Ridge estimators in logistic regression. J R Stat Soc: Ser C: Appl Stat. 1992;41(1):191–201. Le Cessie S, Van Houwelingen JC. Ridge estimators in logistic regression. J R Stat Soc: Ser C: Appl Stat. 1992;41(1):191–201.
26.
go back to reference Cover TM, Thomas JA. Entropy, relative entropy and mutual information. Elements Information Theory. 1991;2:1–55. Cover TM, Thomas JA. Entropy, relative entropy and mutual information. Elements Information Theory. 1991;2:1–55.
30.
go back to reference Bouckaert RR. Choosing Between Two Learning Algorithms Based on Calibrated Tests. Machine Learning, Twentieth International Conference; 2003; Washington DC; 2003. Bouckaert RR. Choosing Between Two Learning Algorithms Based on Calibrated Tests. Machine Learning, Twentieth International Conference; 2003; Washington DC; 2003.
31.
go back to reference Krauss ES, Segal A, Cronin M, Dengler N, Lesser ML, Ahn S, et al. Implementation and validation of the 2013 Caprini score for risk stratification of Arthroplasty patients in the prevention of venous thrombosis. Clin Appl Thromb Hemost. 2019;25:1076029619838066. https://doi.org/10.1177/1076029619838066. Krauss ES, Segal A, Cronin M, Dengler N, Lesser ML, Ahn S, et al. Implementation and validation of the 2013 Caprini score for risk stratification of Arthroplasty patients in the prevention of venous thrombosis. Clin Appl Thromb Hemost. 2019;25:1076029619838066. https://​doi.​org/​10.​1177/​1076029619838066​.
34.
go back to reference Bradley M, Shi A, Khatri V, Schobel S, Silvius E, Kirk A, et al. Prediction of venous thromboembolism using clinical and serum biomarker data from a military cohort of trauma patients. BMJ Military Health. 2020; bmjmilitary-2019-001393. Bradley M, Shi A, Khatri V, Schobel S, Silvius E, Kirk A, et al. Prediction of venous thromboembolism using clinical and serum biomarker data from a military cohort of trauma patients. BMJ Military Health. 2020; bmjmilitary-2019-001393.
Metadata
Title
Predicting venous thromboembolism in hospitalized trauma patients: a combination of the Caprini score and data-driven machine learning model
Authors
Lingxiao He
Lei Luo
Xiaoling Hou
Dengbin Liao
Ran Liu
Chaowei Ouyang
Guanglin Wang
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Emergency Medicine / Issue 1/2021
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-021-00447-x

Other articles of this Issue 1/2021

BMC Emergency Medicine 1/2021 Go to the issue