用机器学习预测冠心病手术后中风风险,准确率超85%。
Machine Learning-Based Model for Postoperative Stroke Prediction in Coronary Artery Disease
- 融合临床、实验室数据,用LASSO和网格搜索优化特征与参数
- SVM模型AUC达0.855,显著优于传统方法
- 发现合并症指数、糖尿病等是关键风险因素,适合术前评估
冠状动脉疾病仍是全球主要死亡原因之一。尽管血运重建治疗(如PCI和CABG)取得进展,术后中风仍不可避免。本研究旨在开发并评估一种复杂的机器学习预测模型,用于评估冠状动脉血运重建患者的术后中风风险。研究基于MIMIC-IV数据库,包含7023名患者,涵盖临床、实验室及共病变量。为减少多重共线性,剔除缺失值超30%或相关系数大于0.9的变量。数据集按70%训练、30%测试划分。采用随机森林填补缺失值,数值变量归一化,分类变量进行独热编码。通过LASSO正则化筛选特征,网格搜索确定超参数。最终使用逻辑回归、XGBoost、SVM和CatBoost进行建模,结合SHAP分析评估各变量的中风风险贡献。SVM模型表现最佳,AUC为0.855(95%置信区间0.829–0.878),优于以往研究中的逻辑回归与CatBoost模型。SHAP分析表明,查尔森共病指数(CCI)、糖尿病、慢性肾病和心力衰竭是术后中风的重要预后因素。研究表明,改进的机器学习方法可降低过拟合,提升预测准确性。仅使用CCI的模型无法像整合独立共病变量的模型那样准确预测术后中风风险。所提方法通过纳入更广泛的临床相关特征,提供更全面、个性化的风险评估,为术前风险评估和靶向干预提供了更优参考。
原文摘要 · Abstract (English)
Coronary artery disease remains one of the leading causes of mortality globally. Despite advances in revascularization treatments like PCI and CABG, postoperative stroke is inevitable. This study aims to develop and evaluate a sophisticated machine learning prediction model to assess postoperative stroke risk in coronary revascularization patients.This research employed data from the MIMIC-IV database, consisting of a cohort of 7023 individuals. Study data included clinical, laboratory, and comorbidity variables. To reduce multicollinearity, variables with over 30% missing values and features with a correlation coefficient larger than 0.9 were deleted. The dataset has 70% training and 30% test. The Random Forest technique interpolated residual dataset missing values. Numerical values were normalized, whereas categorical variables were one-hot encoded. LASSO regularization selected features, and grid search found model hyperparameters. Finally, Logistic Regression, XGBoost, SVM, and CatBoost were employed for predictive modeling, and SHAP analysis assessed stroke risk for each variable. AUC of 0.855 (0.829-0.878) showed that SVM model outperformed logistic regression and CatBoost models in prior research. SHAP research showed that the Charlson Comorbidity Index (CCI), diabetes, chronic kidney disease, and heart failure are significant prognostic factors for postoperative stroke. This study shows that improved machine learning reduces overfitting and improves model predictive accuracy. Models using the CCI alone cannot predict postoperative stroke risk as accurately as those using independent comorbidity variables. The suggested technique provides a more thorough and individualized risk assessment by encompassing a wider range of clinically relevant characteristics, making it a better reference for preoperative risk assessments and targeted intervention.
Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品;中文卡片由大模型生成,请以原文为准。