An Improved Ensemble Method for Predicting Hyperchloremia in Adults With Diabetic Ketoacidosis

Abstract

Diabetic ketoacidosis (DKA) is a serious complication that affects millions of individuals globally and presents significant health complications. Hyperchloremia, an electrolyte imbalance characterized by high levels of chloride in the blood, may result in gastrointestinal problems, kidney damage, and even death, especially in DKA patients. Early detection and treatment of hyperchloremia are of utmost importance in the management of DKA. This study explores the potential of the bootstrap aggregating ensemble with random subspaces machine learning approach to predict the occurrence of hyperchloremia, providing a basis for early intervention and improved patient outcomes. We tested our approach with the retrospective MIMIC-III database containing 1177 DKA patients and compared it with previous studies with an area under the curve (AUC) of 100%. Our approach showed significant performance outperforming other methods. The combination of this approach may enhance the early detection and timely intervention for hyperchloremia cases, ultimately leading to improved patient outcomes and a more effective management of DKA-associated complications. Our work aims to contribute to the development of decision support tools for healthcare professionals, assisting them in making informed decisions for DKA patients, with a focus on preventing and managing hyperchloremia. INDEX TERMS Boosting Aggregating or Bagging Classifier, Diabetic Ketoacidosis (DKA), Hyperchloremia, Machine Learning, Predictive Modelling I. INTRODUCTIONDiabetes, a metabolic disorder, disrupts the regulation of blood glucose levels which can lead to both short-term and long-term health complications, and in severe cases, even death if not effectively managed [1]-[5]. This condition is broadly categorized into two types: type 1 diabetes (TY1D) and type 2 diabetes (TY2D). The pancreas plays a vital role in producing insulin, and serves as a key regulator for blood sugar levels. Insulin acts as a major energy source for muscles and various tissues, facilitating the entry of blood sugar into the body's cells [6]. This process is particularly significant in understanding both TY1D and TY2D as disruptions in insulin production or its effectiveness can lead to distinct metabolic imbalances and complications associated with each type. Both TY1D and TY2D diabetes are chronic diseases that affect millions of people worldwide