Risk factor analysis of device-related infections: value of re-sampling method on the real-world imbalanced dataset

Abstract

Background The incidence of cardiac implantable electronic device infection (CIEDI) is low and usually belongs to the typical imbalanced dataset. We sought to describe our experience on the management of the imbalanced CIEDI dataset. Methods Database from two centers of patients undergoing device implantation from 2001 to 2016 were reviewed retrospectively. Re-sampling technique was used to improve the classifier accuracy. Results CIEDI was identified in 28 out of 4959 procedures (0.56%); a high imbalance existed in the sizes of the patient profiles. In univariate analyses, replacement procedure and male were significantly associated with an increase in CIEDI: (53.6% vs. 23.4, 0.8% vs. 0.3%, P < 0.01). Multivariate logistic regression analysis showed that gender (odds ratio, OR = 3.503), age (OR = 1.032), replacement procedure (OR = 3.503), and use of antibiotics (OR = 0.250) remained as independent predictors of CIEDI (all P < 0.05) after adjustment for diabetes, post-operation fever, and device style, device company. There were 616 under-sampled cases and 123 over-sampled cases in the analyzed cohort after re-sampling. The re-sampling and bootstrap results were robust and largely like the analysis results prior re-sampling method, while use of antibiotics lost the predicting capacity for CIEDI after re-sampling technique (P > 0.05). Conclusion The application of re-sampling techniques can generate useful synthetic samples for the classification of imbalanced data and improve the accuracy of predicting efficacy of CIEDI. The peri-operative assessment should be intensified in male and aged patients as well as patients receiving replacement procedures for the risk of CIEDI.

There is no Dose-response Relationship between Allogeneic Blood Transfusion and Healthcare-associated Infection: A Retrospective Cohort Study

“…The practical signi cance of our ndings might be of reference value in HAI monitoring and infection-related risk assessment. ABT in our study was an associated and apparently signi cant risk factor for the development of HAI, but it was not de ned as a risk factor in China's nosocomial infection surveillance guideline [33], leading to the neglect of ABT in many previous studies [34][35][36]. Given that ABT is such a signi cant and frequently overlooked risk factor for HAI, it is necessary to include ABT as invasive procedures and antimicrobial resistance into the daily targeted surveillance of HAI.…”

There is no Dose-response Relationship between Allogeneic Blood Transfusion and Healthcare-associated Infection: A Retrospective Cohort Study

“…If blood transfusion was unavoidable according to the patient's condition, we recommend administering enough doses to maximize clinical bene t. The practical signi cance of our ndings might be of reference value in HAI monitoring and infection-related risk assessment. ABT in our study was an associated and apparently signi cant risk factor for the development of HAI, but it was not de ned as a risk factor in China's nosocomial infection surveillance guideline [33], leading to the neglect of ABT in many previous studies [34][35][36]. Given that ABT is such a signi cant and frequently overlooked risk factor for HAI, it is necessary to include ABT as invasive procedures and antimicrobial resistance into the daily targeted surveillance of HAI.…”

There is no dose–response relationship between allogeneic blood transfusion and healthcare-associated infection: a retrospective cohort study

“…The practical significance of our findings might be of reference value in HAI monitoring and infection-related risk assessment. ABT in our study was an associated and apparently significant risk factor for the development of HAI, but it was not defined as a risk factor in China’s nosocomial infection surveillance guideline [ 33 ], leading to the neglect of ABT in many previous studies [ 34 – 36 ]. Given that ABT is such a significant and frequently overlooked risk factor for HAI, it is necessary to include ABT as invasive procedures and antimicrobial resistance into the daily targeted surveillance of HAI.…”

“…The practical significance of our findings might be of reference value in HAI monitoring and infection-related risk assessment. ABT in our study was an associated and apparently significant risk factor for the development of HAI, but it was not defined as a risk factor in China's nosocomial infection surveillance guideline [33], leading to the neglect of ABT in many previous studies [34][35][36].…”