Machine learning predicts portal vein thrombosis after splenectomy in patients with portal hypertension: Comparative analysis of three practical models

doi:10.3748/wjg.v28.i32.4681

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 28, Issue 32

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Supplementary Materials of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (4518)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Figures (1-5) series, Tables (1-3) series.

Item

Count

PDF

236

WORD

HTML

2064

Figures (1-5)

294

Tables (1-3)

140

Sum=2810

Featured Article

The chart showing Browse series, Download series.

Item

Count

Browse

270

Download

652

Sum=922

Publishing Process of This Article

Item

Count

Browse

209

Download

577

Sum=786

Aug 28, 2022 (publication date) through Apr 28, 2024

Times Cited of This Article

Times Cited (8)

Journal Information of This Article

Publication Name

World Journal of Gastroenterology

ISSN

1007-9327

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Aug 28, 2022; 28(32): 4681-4697
Published online Aug 28, 2022. doi: 10.3748/wjg.v28.i32.4681

Table 1 Detailed clinical characteristics of 483 patients with portal hypertension

Variable	Training cohort			Validation cohort
Variable	Without PVT (n = 203)	PVT (n =135)	P value	Without PVT (n = 80)	PVT (n = 65)	P value
Sex, n (%)			0.312			0.86
Female	69 (34.0)	38 (28.1)		20 (25.0)	18 (27.7)
Male	134 (66.0)	97 (71.9)		60 (75.0)	47 (72.3)
Age, n (%)			0.179			0.999
< 60 yr	165 (81.3)	118 (87.4%)		71 (88.8)	58 (89.2)
≥ 60 yr	38 (18.7)	17 (12.6%)		9 (11.2)	7 (10.8)
Smoking, n (%)			0.703			0.983
No	167 (82.3)	108 (80.0)		64 (80.0)	51 (78.5)
Yes	36 (17.7)	27 (20.0)		16 (20.0)	14 (21.5)
Alcohol, n (%)			0.577			0.587
No	167 (82.3)	115 (85.2)		69 (86.2)	53 (81.5)
Yes	36 (17.7)	20 (14.8)		11 (13.8)	12 (18.5)
RBC¹ (× 10¹²/L)	3.59 (3.20-3.93)	3.57 (3.21-3.90)	0.69	3.74 (3.49-4.02)	3.55 (3.22-3.93)	0.044
HLB¹ (g/L)	89.3 (78.1-103)	93.2 (82.1-104)	0.093	89.5 (79.5-107)	91.1 (82.8-101)	0.965
WBC¹ (× 10⁹/L)	2.51 (1.83-3.40)	2.18 (1.48-2.87)	0.007	2.46 (1.95-3.21)	2.09 (1.58-2.92)	0.06
N¹ (× 10⁹/L)	1.35 (0.98-2.09)	1.27 (0.85-2.00)	0.177	1.38 (1.06-1.98)	1.15 (0.87-1.77)	0.147
L¹(× 10⁹/L)	0.79 (0.56-1.14)	0.50 (0.38-0.79)	< 0.001	0.78 (0.51-1.11)	0.63 (0.45-0.91)	0.045
NLR¹	1.78 (1.18-2.99)	2.43 (1.42-4.18)	0.003	1.90 (1.23-3.08)	2.16 (1.39-3.16)	0.559
PLT¹ (× 10⁹/L)	48.0 (36.0-64.5)	33.8 (26.0-47.9)	< 0.001	46.0 (32.1-57.0)	35.0 (27.0-48.0)	0.012
PLR¹	60.6 (43.4-97.0)	72.5 (35.0-99.7)	0.779	55.6 (37.9-91.3)	58.8 (31.8-86.8)	0.692
PT¹ (s)	15.5 (14.1-16.6)	15.3 (12.9-16.4)	0.221	15.7 (14.4-16.3)	15.3 (13.9-16.2)	0.294
PTA¹ (%)	64.0 (57.0-73.5)	60.0 (50.0-69.0)	< 0.001	67.0 (57.0-73.0)	63.0 (54.0-72.0)	0.269
INR¹	1.34 (1.23-1.47)	1.42 (1.29-1.62)	< 0.001	1.32 (1.23-1.50)	1.36 (1.23-1.50)	0.519
FIB¹ (g/L)	2.35 (1.62-3.86)	2.52 (1.82-3.78)	0.269	2.29 (1.74-4.14)	2.57 (1.83-3.62)	0.764
APTT¹ (s)	40.7 (37.5-44.8)	40.6 (36.9-44.9)	0.787	41.3 (37.9-44.3)	41.0 (38.5-44.1)	0.822
ALT¹ (U/L)	22.0 (16.0-30.5)	21.0 (15.0-28.0)	0.578	25.5 (17.8-40.0)	18.0 (15.0-27.0)	0.007
AST¹ (U/L)	29.0 (22.0-40.0)	25.0 (22.0-35.0)	0.021	30.5 (24.8-43.5)	25.0 (21.0-34.0)	0.009
ALB¹ (g/L)	35.9 (32.7-39.5)	35.8 (32.6-39.5)	0.881	35.7 (33.1-38.3)	36.4 (33.7-39.6)	0.551
TBIL¹ (μmol/L)	18.1 (12.4-24.6)	18.8 (12.4-27.0)	0.671	18.8 (13.6-24.6)	18.0 (14.4-26.1)	0.796
Child-Pugh grade, n (%)			0.644			0.999
A	146 (71.9)	101 (74.8)		58 (72.5)	48 (73.8)
B	57 (28.1)	34 (25.2)		22 (27.5)	17 (26.2)
EGV, n (%)			0.023			0.001
No	67 (33.0)	62 (45.9)		17 (21.2)	32 (49.2)
Yes	136 (67.0)	73 (54.1)		63 (78.8)	33 (50.8)
SPT¹ (cm)	5.50 (4.60-6.40)	6.40 (5.40-7.55)	< 0.001	5.70 (4.45-6.70)	6.30 (5.30-7.30)	0.034
DPV¹ (cm)	1.30 (1.10-1.40)	1.50 (1.25-1.70)	< 0.001	1.30 (1.10-1.50)	1.40 (1.20-1.60)	0.088
PBT, n (%)			0.126			0.023
No	159 (78.3)	95 (70.4)		67 (83.8)	43 (66.2)
Yes	44 (21.7)	40 (29.6)		13 (16.2)	22 (33.8)
De, n (%)			0.457			0.344
No	16 (7.88)	7 (5.19)		4 (5.00)	6 (9.23)
Yes	187 (92.1)	128 (94.8)		76 (95.0)	59 (90.8)
PLT1¹ (× 10⁹/L)	79.0 (61.0-106)	79.0 (64.0-102)	0.866	74.0 (57.7-93.8)	77.0 (61.0-102)	0.418
PLT3¹ (× 10⁹/L)	103 (78.5-158)	117 (85.0-164)	0.131	98.5 (75.5-140)	112 (81.0-156)	0.122
PPER1¹ (%)	0.59 (0.34-0.88)	1.18 (0.57-2.31)	< 0.001	0.70 (0.36-1.11)	0.87 (0.64-2.03)	0.002
PPER3¹ (%)	1.15 (0.62-2.02)	2.38 (1.52-3.87)	< 0.001	1.32 (0.79-2.04)	2.29 (1.36-3.54)	< 0.001

¹Continuous variables are presented as the median and interquartile range (IQR).

PH: Portal hypertension; PVT: Portal vein thrombosis; RBC: Red blood cells; HLB: Hemoglobin; WBC: White blood cells; N: Neutrophil count; L: Lymphocyte count; NLR: Neutrophil to lymphocyte ratio; PLT: Platelet count; PLR: Platelet to lymphocyte ratio; PT: Prothrombin time; PTA: Prothrombin activity; INR: International normalized ratio; FIB: Fibrinogen; APTT: Activated partial thromboplastin time; ALT: Alanine aminotransaminase; AST: Aspartate aminotransaminase; ALB: Serum albumin; TBIL: Total serum bilirubin; EGV: Esophageal and gastric varices; SPT: Spleen thickness; DPV: Diameter of the portal vein; PBT: Preoperative blood transfusion; De: Devascularization; PLT1: Platelet count at postoperative day 1; PLT3: Platelet count at postoperative day 3; PPER1: Platelet elevation rate at postoperative day 1; PPER3: Platelet elevation rate at postoperative day 3.

Table 2 Univariate and multivariate logistic regression analyses for risk factors associated with portal vein thrombosis in the overall cohort

Variable	Univariate		Multivariate¹
Variable	OR (95%CI)	P value	OR (95%CI)	P value
Sex (female vs male)	1.18 (0.79-1.76)	0.42
Age (< vs ≥ 60 yr)	0.68 (0.40-1.16)	0.16
Smoking (no vs yes)	1.15 (0.73-1.81)	0.56
Alcohol (no vs yes)	0.96 (0.59-1.56)	0.86
RBC² (× 10¹²/L)	0.71 (0.44-1.14)	0.16
HLB² (g/L)	1.01 (0.99-1.02)	0.22
WBC² (× 10⁹/L)	0.87 (0.76-1.00)	0.05
N² (× 10⁹/L)	1.05 (0.98-1.12)	0.20
L² (× 10⁹/L)	0.27 (0.16-0.45)	< 0.001	0.28 (0.14-0.54)	< 0.001
NLR²	1.07 (1.01-1.14)	0.03	1.03 (0.98-1.11)	0.42
PLT² (× 10⁹/L)	0.98 (0.97-0.99)	< 0.001	0.99 (0.98-1.01)	0.98
PLR²	1.00 (1.00-1.00)	0.18
PT² (s)	0.94 (0.89-1.00)	0.07
PTA² (%)	0.97 (0.96-0.99)	< 0.001	0.99 (0.98-1.02)	0.73
INR²	0.98 (0.88-1.09)	0.74
FIB² (g/L)	1.06 (0.93-1.21)	0.42
APTT²(s)	0.99 (0.96-1.01)	0.38
ALT² (U/L)	0.99 (0.98-1.00)	0.16
AST² (U/L)	0.98 (0.97-0.99)	< 0.001	0.99 (0.98-1.00)	0.14
ALB² (g/L)	1.00 (0.97-1.04)	0.97
TBIL² (μmol/L)	1.00 (0.99-1.02)	0.78
Child-Pugh (A vs B)	0.88 (0.59-1.33)	0.56
EGV (no vs yes)	0.48 (0.33-0.69)	< 0.001	0.51 (0.32-0.79)	0.003
SPT² (cm)	1.34 (1.19-1.50)	< 0.001	1.22 (1.06-1.40)	0.005
DPV² (cm)	4.72 (2.69-8.29)	< 0.001	3.57 (1.86-7.03)	< 0.001
PBT (no vs yes)	1.78 (1.17-2.70)	0.01	1.33 (0.79-2.26)	0.28
De (no vs yes)	1.09 (0.53-2.25)	0.81
PLT1² (× 10⁹/L)	1.00 (0.99-1.00)	0.32
PLT3² (× 10⁹/L)	1.00 (1.00-1.00)	0.25
PPER² (%)	2.77 (2.1-3.66)	< 0.001	1.78 (1.24-2.62)	0.002
PPER3² (%)	1.86 (1.58-2.19)	< 0.001	1.43 (1.16-1.77)	< 0.001

¹Forward stepwise analysis.

²Continuous variables.

PVT: Portal vein thrombosis; OR: Odds ratio; CI: Confidence interval; RBC: Red blood cells; HLB: Hemoglobin; WBC: White blood cells; N: Neutrophil count; L: Lymphocyte count; NLR: Neutrophil to lymphocyte ratio; PLT: Platelet count; PLR: Platelet to lymphocyte ratio; PT: Prothrombin time; PTA: Prothrombin activity; INR: International normalized ratio; FIB: Fibrinogen; APTT: Activated partial thromboplastin time; ALT: Alanine aminotransaminase; AST: Aspartate aminotransaminase; ALB: Serum albumin; TBIL: Total serum bilirubin; EGV: Esophageal and gastric varices; SPT: Spleen thickness; DPV: Diameter of the portal vein; PBT: Preoperative blood transfusion; De: Devascularization; PLT1: Platelet count at postoperative day 1; PLT3: Platelet count at postoperative day 3; PPER1: Platelet elevation rate at postoperative day 1; PPER3: Platelet elevation rate at postoperative day 3.

Table 3 Performance of models for portal vein thrombosis risk prediction in different cohorts

	AUC (95%CI)	Sensitivity (95%CI)	Specificity (95%CI)	PPV (95%CI)	NPV (95%CI)	Accuracy (%)	F1	Kappa	Brier
Overall cohort
GLM	0.812 (0.773-0.851)	0.710 (0.642-0.772)	0.799 (0.747-0.844)	0.714 (0.650-0.775)	0.796 (0.740-0.841)	76.2	0.712	0.509	0.169
LSM	0.822 (0.784-0.861)	0.640 (0.569-0.706)	0.869 (0.824-0.906)	0.776 (0.709-0.824)	0.774 (0.718-0.832)	77.4	0.701	0.522	0.163
RFM	0.814 (0.775-0.854)	0.665 (0.595-0.730)	0.852 (0.805-0.891)	0.760 (0.695-0.812)	0.782 (0.727-0.837)	77.4	0.709	0.526	0.168
Training cohort
GLM	0.833 (0.787-0.879)	0.674 (0.588-0.752)	0.877 (0.824-0.919)	0.784 (0.705-0.842)	0.802 (0.736-0.865)	79.6	0.725	0.564	0.157
LSM	0.839 (0.794-0.884)	0.733 (0.650-0.806)	0.828 (0.768-0.877)	0.739 (0.662-0.810)	0.824 (0.759-0.874)	79.0	0.736	0.562	0.153
RFM	0.838 (0.793-0.883)	0.756 (0.674-0.825)	0.808 (0.747-0.860)	0.723 (0.647-0.800)	0.832 (0.769-0.879)	78.7	0.739	0.559	0.154
Validation cohort
GLM	0.769 (0.691-0.846)	0.646 (0.518-0.761)	0.825 (0.724-0.901)	0.750 (0.625-0.839)	0.742 (0.628-0.847)	74.5	0.694	0.477	0.190
LSM	0.826 (0.755-0.897)	0.708 (0.582-0.814)	0.863 (0.767-0.929)	0.807 (0.687-0.883)	0.784 (0.676-0.884)	79.3	0.754	0.577	0.163
RFM	0.777 (0.700-0.853)	0.631 (0.502-0.747)	0.875 (0.782-0.938)	0.804 (0.678-0.876)	0.745 (0.632-0.864)	76.6	0.707	0.516	0.187

AUC: Area under the receiver operating characteristics curve; CI: Confidence interval; PPV: Positive predictive value; NPV: Negative predictive value; GLM: Generalized linear model; LSM: Least absolute shrinkage and selection operator model; RFM: Random forest model.

Citation: Li J, Wu QQ, Zhu RH, Lv X, Wang WQ, Wang JL, Liang BY, Huang ZY, Zhang EL. Machine learning predicts portal vein thrombosis after splenectomy in patients with portal hypertension: Comparative analysis of three practical models. World J Gastroenterol 2022; 28(32): 4681-4697
URL: https://www.wjgnet.com/1007-9327/full/v28/i32/4681.htm
DOI: https://dx.doi.org/10.3748/wjg.v28.i32.4681