Abstract
Patients with chronic obstructive pulmonary disease (COPD) repeat acute exacerbations (AE). Global Initiative for Chronic Obstructive Lung Disease (GOLD) is only available for patients in stable phase. Currently, there is a lack of assessment and prediction methods for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients during hospitalization. To enhance the monitoring and treatment of AECOPD patients, we develop a novel C5.0 decision tree classifier to predict the prognosis of AECOPD hospitalized patients with objective clinical indicators. The medical records of 410 hospitalized AECOPD patients are collected and 28 features including vital signs, medical history, comorbidities and various inflammatory indicators are selected. The overall accuracy of the proposed C5.0 decision tree classifier is 80.3% (65 out of 81 participants) with 95% Confidence Interval (CI):(0.6991, 0.8827) and Kappa 0.6054. In addition, the performance of the model constructed by C5.0 exceeds the C4.5, classification and regression tree (CART) model and the iterative dichotomiser 3 (ID3) model. The C5.0 decision tree classifier helps respiratory physicians to assess the severity of the patient early, thereby guiding the treatment strategy and improving the prognosis of patients.
Highlights
Patients with chronic obstructive pulmonary disease (COPD) repeat acute exacerbations (AE)
A considerable number of studies have shown that inflammatory cells and their secretions in the lungs are closely related to the severity and acute exacerbation of COPD21,22
To build a generic machine model to support the diagnosis of the deterioration and death risk of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) for physicians, we develop a C5.0 decision tree classifier using basic indicators, comorbidity, and inflammatory indicators
Summary
Patients with chronic obstructive pulmonary disease (COPD) repeat acute exacerbations (AE). Global Initiative for Chronic Obstructive Lung Disease (GOLD) has been employed to classify the severity of COPD patients since 201112. Almagro et al took advantage of the charlson index and a questionnaire to study the comorbidities and short-term prognosis in patients hospitalized for acute exacerbation of COPD. A considerable number of studies have shown that inflammatory cells and their secretions in the lungs are closely related to the severity and acute exacerbation of COPD21,22. Most of these studies examined induced sputum and bronchoalveolar lavage fluid, which is difficult to apply to clinical use on a large scale. Some studies have shown that levels of inflammatory markers such as CRP and PCT are related to the severity of COPD patients and can guide the application of anti-infective therapy[24,25]
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