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Determinants of In‐Hospital Mortality After Percutaneous Coronary Intervention: A Machine Learning Approach
- 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.
- Subjects :
- Male
Databases, Factual
medicine.medical_treatment
Big data
New York
Coronary Artery Disease
030204 cardiovascular system & hematology
Machine Learning
risk prediction
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Text mining
Risk Factors
Catheter-Based Coronary and Valvular Interventions
medicine
Data Mining
Humans
Hospital Mortality
Registries
030212 general & internal medicine
Aged
In hospital mortality
business.industry
Age Factors
Editorials
Percutaneous coronary intervention
Stroke Volume
Middle Aged
artificial intelligence
medicine.disease
Treatment Outcome
Editorial
Female
computer‐based model
Medical emergency
Information Technology
Cardiology and Cardiovascular Medicine
business
Subjects
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