Abstract
Prognostic stratification of Hodgkin lymphoma (HL) patients in ICU remains challenging, with conventional scoring systems often overlooking pathophysiological biomarkers. This retrospective cohort study analyzed 1,908 HL patients from the MIMIC-IV database. Multivariate logistic regression and machine learning (ML, gradient-boosting (GBM) was optimized with LASSO regularization) were employed to identify 30-day mortality predictors, validated through SHAP interpretability, calibration curves, and decision curve analysis. Multi-organ dysfunction (AST, BUN, T-Bil), systemic inflammation (NLR, WBC) and APTT emerged as critical mortality determinants, and selected for model construction. GBM achieved superior discrimination (training AUC = 0.89; test AUC = 0.75), SHAP analysis, calibration curve and decision curve analysis (DCA) confirmed clinical utility, outperforming empirical intervention strategies. This study establishes a biomarker-driven ML framework for HL prognosis, integrating renal, hepatic, and inflammatory markers into actionable risk stratification. thereby providing a scientific basis for comprehensive HL management.