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Determinants of In‐Hospital Mortality After Percutaneous Coronary Intervention: A Machine Learning Approach

Authors :
James K. Min
Robert M. Minutello
Gurpreet Singh
Zhuoran Xu
Subhi J. Al'Aref
Gabriel Maliakal
Alexander R. van Rosendael
Mohit Pandey
S. Chiu Wong
Kranthi K. Kolli
Yiye Zhang
Xiaoyue Ma
Jing Wang
Bejamin C. Lee
Source :
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Publication Year :
2019
Publisher :
Ovid Technologies (Wolters Kluwer Health), 2019.

Abstract

Background The ability to accurately predict the occurrence of in‐hospital death after percutaneous coronary intervention is important for clinical decision‐making. We sought to utilize the New York Percutaneous Coronary Intervention Reporting System in order to elucidate the determinants of in‐hospital mortality in patients undergoing percutaneous coronary intervention across New York State. Methods and Results We examined 479 804 patients undergoing percutaneous coronary intervention between 2004 and 2012, utilizing traditional and advanced machine learning algorithms to determine the most significant predictors of in‐hospital mortality. The entire data were randomly split into a training (80%) and a testing set (20%). Tuned hyperparameters were used to generate a trained model while the performance of the model was independently evaluated on the testing set after plotting a receiver‐operator characteristic curve and using the output measure of the area under the curve ( AUC ) and the associated 95% CIs. Mean age was 65.2±11.9 years and 68.5% were women. There were 2549 in‐hospital deaths within the patient population. A boosted ensemble algorithm (AdaBoost) had optimal discrimination with AUC of 0.927 (95% CI 0.923–0.929) compared with AUC of 0.913 for XGB oost (95% CI 0.906–0.919, P =0.02), AUC of 0.892 for Random Forest (95% CI 0.889–0.896, P AUC of 0.908 for logistic regression (95% CI 0.907–0.910, P Conclusions A big data approach that utilizes advanced machine learning algorithms identifies new associations among risk factors and provides high accuracy for the prediction of in‐hospital mortality in patients undergoing percutaneous coronary intervention.

Details

ISSN :
20479980
Volume :
8
Database :
OpenAIRE
Journal :
Journal of the American Heart Association
Accession number :
edsair.doi.dedup.....8387d9311fd14e34057c5bbb6a4595e4
Full Text :
https://doi.org/10.1161/jaha.118.011160