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Predicting the Risk of Mortality and Rehospitalization in Heart Failure Patients: A Retrospective Cohort Study by Machine Learning Approach Publisher Pubmed



Ketabi M1 ; Andishgar A2 ; Fereidouni Z3 ; Sani MM4 ; Abdollahi A5 ; Vali M6 ; Alkamel A7 ; Tabrizi R7, 8
Authors
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Authors Affiliations
  1. 1. Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
  2. 2. USERN Office, Fasa University of Medical Sciences, Fasa, Iran
  3. 3. Department of Medical Surgical Nursing, Fasa University of Medical Science, Fars, Iran
  4. 4. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  6. 6. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
  7. 7. Noncommunicable Diseases Research Center, Fasa University of Medical Science, Fasa, Iran
  8. 8. Clinical Research Development Unit, Fasa University of Medical Sciences, Fasa, Iran

Source: Clinical Cardiology Published:2024


Abstract

Background: Heart failure (HF) is a global problem, affecting more than 26 million people worldwide. This study evaluated the performance of 10 machine learning (ML) algorithms and chose the best algorithm to predict mortality and readmission of HF patients by using The Fasa Registry on Systolic HF (FaRSH) database. Hypothesis: ML algorithms may better identify patients at increased risk of HF readmission or death with demographic and clinical data. Methods: Through comprehensive evaluation, the best-performing model was used for prediction. Finally, all the trained models were applied to the test data, which included 20% of the total data. For the final evaluation and comparison of the models, five metrics were used: accuracy, F1-score, sensitivity, specificity and Area Under Curve (AUC). Results: Ten ML algorithms were evaluated. The CatBoost (CAT) algorithm uses a series of decision tree models to create a nonlinear model, and this CAT algorithm performed the best of the 10 models studied. According to the three final outcomes from this study, which involved 2488 participants, 366 (14.7%) of the patients were readmitted to the hospital, 97 (3.9%) of the patients died within 1 month of the follow-up, and 342 (13.7%) of the patients died within 1 year of the follow-up. The most significant variables to predict the events were length of stay in the hospital, hemoglobin level, and family history of MI. Conclusions: The ML-based risk stratification tool was able to assess the risk of 5-year all-cause mortality and readmission in patients with HF. ML could provide an explicit explanation of individualized risk prediction and give physicians an intuitive understanding of the influence of critical features in the model. © 2024 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.