Development of an XGBoost-based prediction model for wound recurrence risk in diabetic foot ulcer patients treated with antibiotic-loaded bone cement
BackgroundThis study aims to improve the surgical cure rate, develop interventions to reduce the incidence of postoperative nonunion or recurrence of diabetic foot wounds, and formulate an optimal prediction model to quantify the predictive risk value of antibiotic bone-cement failure in the treatme...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2025.1610884/full |
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| author | Yi Zhang Yi Zhang Xingyu Sun Cheng Cheng Nianzong Hou Nianzong Hou Shiliang Han Xin Tang |
| author_facet | Yi Zhang Yi Zhang Xingyu Sun Cheng Cheng Nianzong Hou Nianzong Hou Shiliang Han Xin Tang |
| author_sort | Yi Zhang |
| collection | DOAJ |
| description | BackgroundThis study aims to improve the surgical cure rate, develop interventions to reduce the incidence of postoperative nonunion or recurrence of diabetic foot wounds, and formulate an optimal prediction model to quantify the predictive risk value of antibiotic bone-cement failure in the treatment of diabetic foot.MethodsThe training and test sets were created once the cases were collected. Based on feature correlation, feature importance, and feature weight, LASSO analysis, random forest, and the Pearson correlation coefficient approach were used to identify the features. Artificial neural network, support vector machine, and XGBoost prediction models were built according to the selected optimal features. The receiver operating characteristic curve, precision–recall (PR) curve, and decision curve analysis were utilized to validate the performance of the models and select the optimal prediction model. Lastly, an independent test set was created to assess and determine the best model’s capacity for generalization.ResultsA comparative analysis revealed that the area under the curve (AUC) for the training set of the PRL-XGBoost prediction model was 0.85 and that for the test set was 0.71. This finding suggests that the model exhibits good predictive ability. Moreover, the PR-AUC value of the prediction model was 0.97, indicating that it demonstrates good resistance to overfitting. Additionally, the DCA curve showed that the PRL-XGBoost prediction model has significant application value and practicality. Therefore, PRL-XGBoost was found to be the most effective prediction model.ConclusionsThe findings from this study prove that γ-glutamyl transpeptidase, lipoprotein A, peripheral vascular disease, peripheral neuropathy, and white blood cells are the key indices that affect the surgical outcome. These parameters determine the nutritional and immune status of the lower limb endings, leading to ulceration, infection, and nonunion of the diabetic foot. Hence, the PRL-XGBoost prediction model can be applied for the preoperative evaluation and screening of patients with diabetic foot treated with antibiotic bone cement, resulting in favorable clinical outcomes. |
| format | Article |
| id | doaj-art-13a0c8c50f8d499baec1f9b06d598a7f |
| institution | DOAJ |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj-art-13a0c8c50f8d499baec1f9b06d598a7f2025-08-20T02:46:05ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.16108841610884Development of an XGBoost-based prediction model for wound recurrence risk in diabetic foot ulcer patients treated with antibiotic-loaded bone cementYi Zhang0Yi Zhang1Xingyu Sun2Cheng Cheng3Nianzong Hou4Nianzong Hou5Shiliang Han6Xin Tang7Department of Orthopedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, ChinaDepartment of Hand and Foot Surgery, Zibo Central Hospital, Zibo, Shandong, ChinaSchool of Mechanical and Electrical Engineering, Jining University, Jining, ChinaDepartment of Medical Record Management, Zibo Central Hospital, Zibo, Shandong, ChinaDepartment of Hand and Foot Surgery, Zibo Central Hospital, Zibo, Shandong, ChinaCenter of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, ChinaDepartment of Hand and Foot Surgery, Zibo Central Hospital, Zibo, Shandong, ChinaDepartment of Orthopedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, ChinaBackgroundThis study aims to improve the surgical cure rate, develop interventions to reduce the incidence of postoperative nonunion or recurrence of diabetic foot wounds, and formulate an optimal prediction model to quantify the predictive risk value of antibiotic bone-cement failure in the treatment of diabetic foot.MethodsThe training and test sets were created once the cases were collected. Based on feature correlation, feature importance, and feature weight, LASSO analysis, random forest, and the Pearson correlation coefficient approach were used to identify the features. Artificial neural network, support vector machine, and XGBoost prediction models were built according to the selected optimal features. The receiver operating characteristic curve, precision–recall (PR) curve, and decision curve analysis were utilized to validate the performance of the models and select the optimal prediction model. Lastly, an independent test set was created to assess and determine the best model’s capacity for generalization.ResultsA comparative analysis revealed that the area under the curve (AUC) for the training set of the PRL-XGBoost prediction model was 0.85 and that for the test set was 0.71. This finding suggests that the model exhibits good predictive ability. Moreover, the PR-AUC value of the prediction model was 0.97, indicating that it demonstrates good resistance to overfitting. Additionally, the DCA curve showed that the PRL-XGBoost prediction model has significant application value and practicality. Therefore, PRL-XGBoost was found to be the most effective prediction model.ConclusionsThe findings from this study prove that γ-glutamyl transpeptidase, lipoprotein A, peripheral vascular disease, peripheral neuropathy, and white blood cells are the key indices that affect the surgical outcome. These parameters determine the nutritional and immune status of the lower limb endings, leading to ulceration, infection, and nonunion of the diabetic foot. Hence, the PRL-XGBoost prediction model can be applied for the preoperative evaluation and screening of patients with diabetic foot treated with antibiotic bone cement, resulting in favorable clinical outcomes.https://www.frontiersin.org/articles/10.3389/fendo.2025.1610884/fullXGBoostdecision curve analysisfeature selectiondiabetic foot ulcerationantibiotic bone cementdiabetic foot |
| spellingShingle | Yi Zhang Yi Zhang Xingyu Sun Cheng Cheng Nianzong Hou Nianzong Hou Shiliang Han Xin Tang Development of an XGBoost-based prediction model for wound recurrence risk in diabetic foot ulcer patients treated with antibiotic-loaded bone cement Frontiers in Endocrinology XGBoost decision curve analysis feature selection diabetic foot ulceration antibiotic bone cement diabetic foot |
| title | Development of an XGBoost-based prediction model for wound recurrence risk in diabetic foot ulcer patients treated with antibiotic-loaded bone cement |
| title_full | Development of an XGBoost-based prediction model for wound recurrence risk in diabetic foot ulcer patients treated with antibiotic-loaded bone cement |
| title_fullStr | Development of an XGBoost-based prediction model for wound recurrence risk in diabetic foot ulcer patients treated with antibiotic-loaded bone cement |
| title_full_unstemmed | Development of an XGBoost-based prediction model for wound recurrence risk in diabetic foot ulcer patients treated with antibiotic-loaded bone cement |
| title_short | Development of an XGBoost-based prediction model for wound recurrence risk in diabetic foot ulcer patients treated with antibiotic-loaded bone cement |
| title_sort | development of an xgboost based prediction model for wound recurrence risk in diabetic foot ulcer patients treated with antibiotic loaded bone cement |
| topic | XGBoost decision curve analysis feature selection diabetic foot ulceration antibiotic bone cement diabetic foot |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1610884/full |
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