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KMID : 0390320210310020039
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Chungbuk Medical Journal
2021 Volume.31 No. 2 p.39 ~ p.46
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K-means clustering of serum creatinine in patients undergoing general surgery
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Yoo Kwon-Cheol
Jang Lee-Chan
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Abstract
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In preoperative laboratory tests for general surgery, Doctors evaluate the levels of serum creatinine, which is an estimation of glomerular filtration rate (eGFR). The eGFR is necessary for dialysis, management of kidney disease and adjustment of drug dosage. In case of normal serum creatinine levels and absence of chronic kidney disease or kidney damage, it is unnecessary to test for eGFR and/or 24-hour urine creatinine levels. Adult patients are routinely tested for eGFR but not 24-hour urine creatinine levels. The 24-hour urine creatinine test is required for exact GFR and is usually not tested in patients that do not have kidney disease. We aim to classify the serum creatinine levels into 5 groups by using k-means clustering and to compare it with eGFR level, both obtained from preoperative lab tests of patients admitted to the general surgery department. To perform K-means clustering, the data (serum creatinine levels and eGFR) of 87908 patients were collected over a span of 17 years (Oct 9, 2002 - Nov 12,2019) from Chungbuk National University Hospital. These patients were admitted to the general surgery department and were aged between 19 to 100 years old K-means clustering was performed by assigning k=5, the resulting clusters were: 0.78, 1,.14, 3.05, 6.53, and 11.58. Whereas normal levels were separated by k=2. Normal serum creatinine level was less than 1.2 mg/dL and was too broad. The eGFR was calculated based on age, sex, and serum creatinine level. In more than 50% of cases, the serum creatinine levels were normal. When the level of serum creatinine is less than 1.2 mg/dL. Because eGFR was divided in 5 classifications, k-means clustering using 5 make two parts even if the level of serum creatinine is normal. A new classification of the level of serum creatinine levels may be necessary in general surgery using mulitiple k(3,4,5,6,7) and large datasets. The eGFR may not be routinely used when the level of serum creatinine is normal in preoperative laboratory tests for general surgery.
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KEYWORD
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K-means, Creatinine, eGFR
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