Chen Shiyu, Hu Weiwei, Yang Yuhui, Cai Jiaxin, Luo Yaqi, Gong Lingmin, Li Yemian, Si Aima, Zhang Yuxiang, Liu Sitong, Mi Baibing, Pei Leilei, Zhao Yaling, Chen Fangyao
Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
Department of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
J Clin Med. 2023 Jan 21;12(3):870. doi: 10.3390/jcm12030870.
Since most patients with heart failure are re-admitted to the hospital, accurately identifying the risk of re-admission of patients with heart failure is important for clinical decision making and management. This study plans to develop an interpretable predictive model based on a Chinese population for predicting six-month re-admission rates in heart failure patients. Research data were obtained from the PhysioNet portal. To ensure robustness, we used three approaches for variable selection. Six different machine learning models were estimated based on selected variables. The ROC curve, prediction accuracy, sensitivity, and specificity were used to evaluate the performance of the established models. In addition, we visualized the optimized model with a nomogram. In all, 2002 patients with heart failure were included in this study. Of these, 773 patients experienced re-admission and a six-month re-admission incidence of 38.61%. Based on evaluation metrics, the logistic regression model performed best in the validation cohort, with an AUC of 0.634 (95%CI: 0.599-0.646) and an accuracy of 0.652. A nomogram was also generated. The established prediction model has good discrimination ability in predicting. Our findings are helpful and could provide useful information for the allocation of healthcare resources and for improving the quality of survival of heart failure patients.
由于大多数心力衰竭患者会再次入院,准确识别心力衰竭患者再次入院的风险对于临床决策和管理至关重要。本研究计划基于中国人群开发一种可解释的预测模型,用于预测心力衰竭患者的六个月再入院率。研究数据来自PhysioNet门户。为确保稳健性,我们使用了三种变量选择方法。基于选定变量估计了六种不同的机器学习模型。采用ROC曲线、预测准确性、敏感性和特异性来评估所建立模型的性能。此外,我们用列线图直观展示了优化后的模型。本研究共纳入2002例心力衰竭患者。其中,773例患者再次入院,六个月再入院发生率为38.61%。基于评估指标,逻辑回归模型在验证队列中表现最佳,AUC为0.634(95%CI:0.599-0.646),准确性为0.652。还生成了一个列线图。所建立的预测模型在预测方面具有良好的辨别能力。我们的研究结果很有帮助,可为医疗资源分配和改善心力衰竭患者的生存质量提供有用信息。