Introduction
Methods
Study cohort and data
Statistical analysis
Results
Study cohort
Factors | Overall | Training set | Validation set | P-value | |
---|---|---|---|---|---|
N | 1028 | 720 | 308 | ||
Survival time (Days) | 642.50 [94.00, 2385.00] | 624.00 [96.75, 2259.25] | 695.50 [80.75, 2562.75] | 0.641 | |
Status = Dead (%) | 325 (31.6) | 229 (31.8) | 96 (31.2) | 0.898 | |
Gender = Male (%) | 583 (56.7) | 402 (55.8) | 181 (58.8) | 0.423 | |
Age (Years) | 65.00 [56.00, 74.00] | 66.00 [56.00, 75.00] | 64.00 [54.75, 73.00] | 0.234 | |
Ethnicity (%) | 0.415 | ||||
Asian | 54 (5.3) | 41 (5.7) | 13 (4.2) | ||
Black | 123 (12.0) | 91 (12.6) | 32 (10.4) | ||
Other | 114 (11.1) | 75 (10.4) | 39 (12.7) | ||
White | 737 (71.7) | 513 (71.2) | 224 (72.7) | ||
BMI (kg/m2) | 27.80 [24.40, 31.60] | 27.67 [24.40, 31.67] | 28.00 [24.48, 31.05] | 0.972 | |
Type of cancer (%) | 0.165 | ||||
Respiratory system | 144 (14.0) | 101 (14.0) | 43 (14.0) | ||
Digestive system | 75 (7.3) | 47 (6.5) | 28 (9.1) | ||
Reproductive organ of the male | 57 (5.5) | 39 (5.4) | 18 (5.8) | ||
Urinary system | 48 (4.7) | 38 (5.3) | 10 (3.2) | ||
Breast | 35 (3.4) | 27 (3.8) | 8 (2.6) | ||
Lymphatic and hematopoietic systems | 21 (2.0) | 19 (2.6) | 2 (0.6) | ||
Skin and soft tissue | 15 (1.5) | 10 (1.4) | 5 (1.6) | ||
Reproductive organ of the female | 5 (0.5) | 4 (0.6) | 1 (0.3) | ||
Ill-defined, unspecified sites | 509 (49.5) | 361 (50.1) | 148 (48.1) | ||
Other | 119 (11.6) | 74 (10.3) | 45 (14.6) | ||
Treatment | Mechanical ventilation = Yes (%) | 92 (8.9) | 64 (8.9) | 28 (9.1) | 1 |
Radiotherapy = Yes (%) | 79 (7.7) | 58 (8.1) | 21 (6.8) | 0.579 | |
Parenteral nutrition = Yes (%) | 88 (8.6) | 67 (9.3) | 21 (6.8) | 0.236 | |
Chemotherapy = Yes (%) | 389 (37.8) | 273 (37.9) | 116 (37.7) | 0.995 | |
Complications | AKI = Yes (%) | 485 (47.2) | 340 (47.2) | 145 (47.1) | 1 |
Hepatic metastases = Yes (%) | 384 (37.4) | 260 (36.1) | 124 (40.3) | 0.234 | |
Pulmonary metastasis = Yes (%) | 266 (25.9) | 179 (24.9) | 87 (28.2) | 0.29 | |
Brain metastases = Yes (%) | 230 (22.4) | 167 (23.2) | 63 (20.5) | 0.377 | |
Acidosis = Yes (%) | 288 (28.0) | 202 (28.1) | 86 (27.9) | 1 | |
RF = Yes (%) | 365 (35.5) | 252 (35.0) | 113 (36.7) | 0.655 | |
Heart failure = Yes (%) | 221 (21.5) | 155 (21.5) | 66 (21.4) | 1 | |
Blood count | MCH (%) | 29.90 [28.20, 31.50] | 29.90 [28.20, 31.50] | 30.00 [28.30, 31.50] | 0.701 |
MCHC (%) | 33.30 [32.30, 34.20] | 33.30 [32.30, 34.20] | 33.35 [32.38, 34.20] | 0.723 | |
MCV (%) | 90.00 [85.00, 94.00] | 90.00 [85.00, 93.00] | 89.50 [85.00, 94.00] | 0.789 | |
Atypical lymphocytes (%) | 0.26 [0.00, 0.91] | 0.24 [0.00, 0.83] | 0.35 [0.00, 1.00] | 0.097 | |
Bands (%) | 1.90 [0.00, 3.67] | 1.83 [0.00, 3.64] | 2.00 [0.00, 3.72] | 0.758 | |
Metamyelocytes (%) | 0.44 [0.00, 1.02] | 0.46 [0.00, 1.00] | 0.39 [0.00, 1.02] | 0.918 | |
Biochemical | ALT | 0.418 | |||
< 40 U/L | 859 (83.6) | 596 (82.8) | 263 (85.4) | ||
40–120 U/L | 135 (13.1) | 97 (13.5) | 38 (12.3) | ||
121–400 U/L | 23 (2.2) | 17 (2.4) | 6 (1.9) | ||
> 400 U/L | 11 (1.1) | 10 (1.4) | 1 (0.3) | ||
ALP | 0.79 | ||||
< 40 U/L | 15 (1.5) | 12 (1.7) | 3 (1.0) | ||
40–100 U/L | 597 (58.1) | 414 (57.5) | 183 (59.4) | ||
101–400 U/L | 375 (36.5) | 266 (36.9) | 109 (35.4) | ||
> 400 U/L | 41 (4.0) | 28 (3.9) | 13 (4.2) | ||
AST | 0.135 | ||||
\(\le\) 40 U/L | 891 (86.7) | 632 (87.8) | 259 (84.1) | ||
> 40 U/L | 137 (13.3) | 88 (12.2) | 49 (15.9) | ||
Creatinine (mg/dL) | 0.90 [0.70, 1.20] | 0.90 [0.70, 1.20] | 0.90 [0.70, 1.20] | 0.962 | |
Potassium (mmol/L) | 4.09 [3.87, 4.30] | 4.10 [3.88, 4.30] | 4.06 [3.84, 4.26] | 0.182 | |
Creatinine kinase MB (ng/mL) | 4.00 [2.46, 7.00] | 4.00 [2.00, 6.85] | 4.00 [3.00, 7.00] | 0.149 | |
Albumin (g/dL) | 3.80 [3.30, 4.20] | 3.80 [3.30, 4.20] | 3.80 [3.27, 4.30] | 0.848 | |
Total protein (g/dL) | 6.51 [6.18, 6.93] | 6.52 [6.18, 6.97] | 6.50 [6.18, 6.89] | 0.65 | |
Calcium (mg/dL) | 9.10 [8.60, 9.60] | 9.10 [8.60, 9.60] | 9.20 [8.60, 9.51] | 0.831 | |
Chloride (mmol/L) | 102.00 [99.00, 104.00] | 102.00 [99.00, 104.00] | 102.00 [99.00, 104.00] | 0.17 | |
Blood gas | pO2 > 80 (%) | 71 (6.9) | 58 (8.1) | 13 (4.2) | 0.037 |
pCO2 (mmHg) | 40.00 [35.00, 44.89] | 40.00 [35.00, 45.00] | 41.00 [36.00, 44.26] | 0.363 | |
Base excess (mmol/L) | 0.00 [-3.00, 1.00] | 0.00 [-3.02, 1.00] | − 0.16 [− 3.00, 1.00] | 0.8 | |
Calculated total CO2 (mEq/L) | 25.00 [22.10, 28.00] | 25.00 [22.00, 28.00] | 25.00 [23.00, 27.00] | 0.945 | |
Free calcium (mmol/L) | 1.12 [1.10, 1.16] | 1.13 [1.10, 1.16] | 1.12 [1.10, 1.16] | 0.942 | |
Lactate (mmol/L) | 1.61 [1.30, 1.96] | 1.60 [1.30, 1.97] | 1.62 [1.30, 1.95] | 0.554 | |
pH | 7.38 [7.35, 7.43] | 7.38 [7.35, 7.43] | 7.38 [7.35, 7.43] | 0.484 | |
Anion gap (mmol/L) | 15.00 [13.00, 17.00] | 15.00 [13.00, 17.00] | 15.00 [13.00, 17.00] | 0.428 | |
Bicarbonate (mmol/L) | 26.00 [24.00, 28.00] | 26.00 [24.00, 28.00] | 26.00 [24.00, 28.00] | 0.875 | |
Scores | APSIII | 41.00 [31.00, 53.00] | 40.00 [31.00, 53.00] | 41.50 [32.00, 53.00] | 0.438 |
SOFA | 3.00 [2.00, 6.00] | 3.00 [2.00, 6.00] | 3.00 [2.00, 6.00] | 0.359 | |
SAPSII | 41.00 [33.00, 48.00] | 41.00 [33.00, 48.00] | 40.00 [32.00, 49.00] | 0.734 |
Feature selection and model building
Factors | Levels | Univariate analysis | Multivariate analysis | |||
---|---|---|---|---|---|---|
HR (95% CI) | P-value | HR (95% CI) | P-value | |||
Demography | Age (Years) | 1.01 (1.00–1.02) | 0.0628 | |||
Gender | Female (Reference) | |||||
Male | 1.10 (0.85–1.43) | 0.4718 | ||||
Ethnicity | Asian (Reference) | |||||
Black | 0.79 (0.45–1.37) | 0.4017 | ||||
Other | 0.69 (0.37–1.29) | 0.2412 | ||||
White | 0.68 (0.42–1.1) | 0.1136 | ||||
BMI (kg/m2) | 1.00 (1.00–1.00) | 0.9116 | ||||
Cancers | Breast (Reference) | |||||
Digestive system | 2.09 (0.78–5.64) | 0.1438 | ||||
Reproductive organ of the female | 0 (0–Inf) | 0.9926 | ||||
Ill-defined, unspecified sites | 1.96 (0.80–4.79) | 0.1403 | ||||
Lymphatic and hematopoietic systems | 1.27 (0.40–4.03) | 0.6818 | ||||
Other | 1.49 (0.55–4.03) | 0.4353 | ||||
Reproductive organ of the male | 1.32 (0.44–3.94) | 0.6195 | ||||
Respiratory system | 2.14 (0.84–5.47) | 0.1127 | ||||
Skin and soft tissue | 0.45 (0.05–3.84) | 0.4648 | ||||
Urinary system | 0.96 (0.31–2.96) | 0.9503 | ||||
Complications | Acidosis | No (Reference) | ||||
Yes | 0.82 (0.62–1.08) | 0.1581 | ||||
AKI | No (Reference) | |||||
Yes | 0.96 (0.74–1.25) | 0.7829 | ||||
HF | No (Reference) | |||||
Yes | 0.75 (0.55–1.04) | 0.084 | ||||
RF | No (Reference) | |||||
Yes | 2.85 (2.18–3.72) | < 0.0001* | 2.08 (1.58–2.75) | < 0.0001* | ||
Pulmonary metastasis | No (Reference) | |||||
Yes | 1.08 (0.81–1.45) | 0.5838 | ||||
Hepatic metastases | No (Reference) | |||||
Yes | 1.76 (1.36–2.29) | < 0.0001* | 1.88 (1.43–2.48) | < 0.0001* | ||
Brain metastases | No (Reference) | |||||
Yes | 1.30 (0.96–1.75) | 0.0902 | ||||
Treatments | Chemotherapy | No (Reference) | ||||
Yes | 0.61 (0.47–0.80) | 0.0003* | 0.61 (0.46–0.81) | 0.0006* | ||
Radiotherapy | No (Reference) | |||||
Yes | 0.86 (0.53–1.39) | 0.5389 | ||||
Mechanical ventilation | No (Reference) | |||||
Yes | 1.36 (0.94–1.97) | 0.103 | ||||
Parenteral nutrition | No (Reference) | |||||
Yes | 0.96 (0.62–1.48) | 0.8446 | ||||
Blood count | MCH (%) | 0.99 (0.95–1.04) | 0.7346 | |||
MCHC (%) | 0.90 (0.83–0.98) | 0.0112 | ||||
MCV (%) | 1.01 (0.99–1.02) | 0.4553 | ||||
Metamyelocytes (%) | 1.10 (1.02–1.18) | 0.0096 | ||||
Bands (%) | 1.03 (1.00–1.05) | 0.018 | ||||
Atypical lymphocytes (%) | 0.95 (0.86–1.05) | 0.334 | ||||
Biochemical | Albumin (g/dL) | 0.57 (0.47–0.68) | < 0.0001* | 0.74 (0.61–0.9) | 0.0032* | |
ALP (U/L) | < 40 | — | ||||
40–100 | 1.15 (0.43, 3.12) | 0.8 | ||||
101–400 | 1.96 (0.73, 5.31) | 0.2 | ||||
> 400 | 5.34 (1.86, 15.4) | 0.002 | ||||
ALT (U/L) | < 40 (Reference) | |||||
40–120 | 1.18 (0.87, 1.62) | 0.3 | ||||
121–400 | 1.92 (1.12, 3.29) | 0.017 | ||||
> 400 | 1.46 (0.54, 3.91) | 0.5 | ||||
AST (U/L) | \(\le\) 40 (Reference) | |||||
> 40 | 1.28 (0.90–1.83) | 0.1755 | ||||
Creatinine (mg/dL) | 1.03 (0.99–1.08) | 0.1763 | ||||
Creatinine kinase MB (ng/mL) | 1.00 (0.99–1.00) | 0.6714 | ||||
Potassium (mmol/L) | 1.05 (0.83–1.34) | 0.6801 | ||||
Total protein (g/dL) | 0.67 (0.58–0.79) | < 0.0001* | 0.76 (0.64–0.91) | 0.0028* | ||
Calcium (mg/dL) | 0.98 (0.83–1.16) | 0.8104 | ||||
Chloride (mmol/L) | 0.93 (0.91–0.96) | < 0.0001* | 0.95 (0.92–0.98) | 0.0008* | ||
Blood gas | Anion gap (mmol/L) | 1.08 (1.04–1.12) | 0.0002* | |||
Base excess (mmol/L) | 0.98 (0.96–1.01) | 0.1342 | ||||
Bicarbonate (mmol/L) | 0.96 (0.92–1.00) | 0.0314 | ||||
Calculated total CO2 (mEq/L) | 0.99 (0.96–1.02) | 0.5118 | ||||
Free calcium (mmol/L) | 4.96 (1.18–20.93) | 0.0292 | ||||
Lactate (mmol/L) | 1.52 (1.26–1.83) | < 0.0001* | 1.38 (1.14–1.67) | 0.0011* | ||
pCO2 (mmHg) | 0.99 (0.97–1.01) | 0.3055 | ||||
pO2 (mmHg) | < 80 (Reference) | |||||
\(\ge\) 80 | 1.25 (0.83–1.89) | 0.2796 | ||||
pH | 0.82 (0.09–7.94) | 0.8656 | ||||
Scores | SAPSII | 1.04 (1.03–1.04) | < 0.0001* | 1.02 (1.01–1.03) | 0.0017* | |
APSIII | 1.02 (1.02–1.03) | < 0.0001* | 1.01 (1–1.02) | 0.0030* | ||
SOFA | 1.15 (1.11–1.18) | < 0.0001* |