Model for Predicting the Risk of Bronchopleural Fistula After Pneumonectomy for Destructive Pulmonary Tuberculosis

Abstract

Introduction: Predicting various events based on influencing factors is important for statistical analysis in medical research. Unfortunately, mathematical models are rarely built on the identified factors.Objective: To develop a model to predict the risk of bronchopleural fistula after pneumonectomy for destructive pulmonary tuberculosis.Materials and methods: We analyzed medical records of 198 patients who underwent pneumonectomy. Of them 6 patients (3%) developed a bronchopleural fistula. We used machine learning algorithms such as ridge regression, support vector machine, random forest, and CatBoost, the Jupyter open­source development environment, and Python 3.6 to build prediction models. ROC analysis was used to evaluate the quality of the binary classification.Results: We built 4 models to predict the risk of bronchopleural fistula. Their ROC AUC were as follows: ridge regression – 0.88, support vector machine – 0.87, CatBoost – 0.75, and random forest – 0.74. The model based on the ridge regression showed the best ROC AUC. Based on the coordinates of the ROC curve, the threshold value of 1.9% provides the maximum total sensitivity and specificity (100% and 68.8%, respectively).Conclusions: The developed model has a high predictive ability, which allows focusing on the patient group with an increased risk of bronchopleural fistula and justifying the need for preventive measures.