Yau Fei-Fei Flora, Chiu I-Min, Wu Kuan-Han, Cheng Chi-Yung, Lee Wei-Chieh, Chen Huang-Chung, Cheng Cheng-I, Chen Tien-Yu
Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Digit Health. 2024 Aug 30;10:20552076241277030. doi: 10.1177/20552076241277030. eCollection 2024 Jan-Dec.
Readmission to the coronary care unit (CCU) has significant implications for patient outcomes and healthcare expenditure, emphasizing the urgency to accurately identify patients at high readmission risk. This study aims to construct and externally validate a predictive model for CCU readmission using machine learning (ML) algorithms across multiple hospitals.
Patient information, including demographics, medical history, and laboratory test results were collected from electronic health record system and contributed to a total of 40 features. Five ML models: logistic regression, random forest, support vector machine, gradient boosting, and multilayer perceptron were employed to estimate the readmission risk.
The gradient boosting model was selected demonstrated superior performance with an area under the receiver operating characteristic curve (AUC) of 0.887 in the internal validation set. Further external validation in hold-out test set and three other medical centers upheld the model's robustness with consistent high AUCs, ranging from 0.852 to 0.879.
The results endorse the integration of ML algorithms in healthcare to enhance patient risk stratification, potentially optimizing clinical interventions, and diminishing the burden of CCU readmissions.
再次入住冠心病监护病房(CCU)对患者的治疗结果和医疗费用有重大影响,这凸显了准确识别高再入院风险患者的紧迫性。本研究旨在构建并在外部验证一个使用机器学习(ML)算法的CCU再入院预测模型,该模型适用于多家医院。
从电子健康记录系统中收集患者信息,包括人口统计学、病史和实验室检查结果,共得到40个特征。使用了五个ML模型:逻辑回归、随机森林、支持向量机、梯度提升和多层感知器来估计再入院风险。
所选的梯度提升模型表现出色,在内部验证集中,受试者工作特征曲线(AUC)下面积为0.887。在保留测试集和其他三个医疗中心进行的进一步外部验证支持了该模型的稳健性,AUC一致较高,范围从0.852到0.879。
研究结果支持在医疗保健中整合ML算法,以加强患者风险分层,可能优化临床干预,并减轻CCU再入院负担。