Comparison of machine learning and nomogram to predict 30-day in-hospital mortality in patients with acute myocardial infarction combined with cardiogenic shock: a retrospective study based on the eICU-CRD and MIMIC-IV databases.

BACKGROUND

To evaluate the predictive utility of machine learning and nomogram in predicting in-hospital mortality in patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS), and to visualize the model results in order to analyze the impact of these predictors on the patients' prognosis.

METHODS

A retrospective analysis was conducted on 332 adult patients who were diagnosed with AMI-CS and admitted to the ICU for the first time within the eICU Collaborative Research Database (eICU-CRD). AdaBoost, XGBoost, LightGBM, Random Forest and logistic regression nomogram were developed utilizing the random forest recursive elimination (RF-RFE) and least absolute shrinkage and selection operator (LASSO) algorithms for feature selection.

RESULTS

Compared to the machine learning models, the nomogram demonstrated superior predictive accuracy for mortality in patients with AMI-CS, with an AUC value of 0.869 (95% CI: 0.803, 0.883) and an F1 score of 0.897 for the internal test set of nomogram, and an AUC of 0.770 (95% CI: 0.702, 0.801) and an F1 score of 0.832 for the external validation set.

CONCLUSIONS

Nomogram enhance the interpretability and transparency of the models, leading to more reliable prognostic predictions for AMI-CS patients. This facilitates clinicians in making precise decisions, thereby enhancing patient prognosis.