Academic Journal
Development of a LightGBM-based survival prediction model for major burn patients using LDH/LYM ratio as the core predictor.
| Title: | Development of a LightGBM-based survival prediction model for major burn patients using LDH/LYM ratio as the core predictor. |
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| Authors: | Sun N; Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, PR China., Fan H; Department of Burn and Plastic Surgery, No.971 Hospital of the People's Liberation Army Navy, Qingdao, PR China., Zhu L; Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, PR China., Yi W; Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, PR China., Zhang L; Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, PR China., Wang G; Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, PR China. Electronic address: 13023225660@163.com., Wu G; Department of Burn Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, PR China. Electronic address: 18019359841@163.com. |
| Source: | Burns : journal of the International Society for Burn Injuries [Burns] 2026 Aug; Vol. 52 (6), pp. 108022. Date of Electronic Publication: 2026 Apr 17. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8913178 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1409 (Electronic) Linking ISSN: 03054179 NLM ISO Abbreviation: Burns Subsets: MEDLINE |
| Imprint Name(s): | Publication: Amsterdam : Elsevier Original Publication: [Guildford, Surrey, UK] : Butterworths, [c1989- |
| MeSH Terms: | Burns*/mortality , Burns*/blood , L-Lactate Dehydrogenase*/blood , Boosting Machine Learning Algorithms*, Biomarkers/blood ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Area Under Curve ; Body Surface Area ; Kaplan-Meier Estimate ; Lymphocyte Count ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; ROC Curve ; Prediction Methods, Machine |
| Abstract: | Background: Patients with extensive burns face a high mortality risk. Early identification of prognostic indicators may facilitate timely interventions that substantially improve outcomes and reduce mortality. The lactate dehydrogenase-to-lymphocyte ratio (LDH/LYM), a composite biomarker reflecting systemic inflammation severity, has not been previously evaluated for its predictive utility in burn populations. This retrospective study aimed to validate the prognostic value of LDH/LYM in patients with extensive burns and establish a predictive model to guide clinical decision-making. Methods: A retrospective analysis was conducted on 365 patients with extensive burns admitted to the Burn ICU of Changhai Hospital during 2023. Independent prognostic factors were identified via univariate and multivariate analyses. The predictive performance of these factors was evaluated using receiver operating characteristic (ROC) curve analysis and Kaplan-Meier survival analysis. Additionally, a Light Gradient Boosting Machine (LightGBM) algorithm was applied to identify key predictors and validate the findings. Results: Multivariate analysis identified age, total body surface area (TBSA) burned, and the LDH/LYM ratio as independent prognostic factors. The area under the curve (AUC) for TBSA and LDH/LYM alone was 0.814 and 0.785, respectively, while their combination achieved a superior AUC of 0.88. Stratification using the optimal LDH/LYM cutoff of 186.361 revealed determined by the Youden index significantly different survival curves between high- and low-ratio groups (HR = 0.074, p < 0.001). The LightGBM model ranked TBSA, blood urea nitrogen (BUN), and LDH/LYM as the top three mortality predictors, with a combined prediction accuracy of 0.849 and an AUC of 0.916. Conclusion: This study established that the LDH/LYM ratio is an independent prognostic determinant for patients with extensive burns, with predictive significance comparable to the TBSA and age, and its prognostic value was confirmed through LightGBM-based feature importance ranking. (Copyright © 2026 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.) |
| Competing Interests: | Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Extensive burns; LDH/LYM ratio; LightGBM model; Prognosis |
| Substance Nomenclature: | 0 (Biomarkers) EC 1.1.1.27 (L-Lactate Dehydrogenase) |
| Entry Date(s): | Date Created: 20260512 Date Completed: 20260611 Latest Revision: 20260615 |
| Update Code: | 20260615 |
| DOI: | 10.1016/j.burns.2026.108022 |
| PMID: | 42119495 |
| Database: | MEDLINE |
| ISSN: | 1879-1409 |
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| DOI: | 10.1016/j.burns.2026.108022 |