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Cardiac patients' surgery outcome and associated factors in Ethiopia: application of machine learning
Melaku Tadege1,2,3, Awoke Seyoum Tegegne4, Zelalem G Dessie4,5
1College of Science, Bahir Dar University, Bahir Dar, Ethiopia. melakutadege@yahoo.com.
Insights
This study identified key predictors of death in Ethiopian cardiac patients, including age, oxygen saturation, ejection fraction, and creatinine levels. These findings highlight critical factors for improving cardiovascular disease outcomes in the region.
Area of Science:
- Cardiology
- Public Health
- Medical Informatics
Background:
- Cardiovascular diseases (CVDs) pose a significant public health challenge in Sub-Saharan Africa, particularly in Ethiopia.
- Unlike developed nations, Ethiopia faces a high burden of preventable heart disease.
Purpose of the Study:
- To determine the prevalence of death among cardiac patients in Ethiopia.
- To identify significant risk factors associated with mortality in this patient population.
Main Methods:
- Retrospective cohort study analyzing data from 1520 cardiac surgery patients (2012-2023).
- Machine learning algorithms, including logistic regression, were employed for data analysis.
- Model performance was evaluated using Area Under the Curve (AUC) and lift values.
Main Results:
- Logistic regression demonstrated the best performance (AUC value) for predicting mortality.
- Significant predictors of death included age, saturated oxygen, ejection fraction, duration of hospital stay post-surgery, waiting time for surgery, hemoglobin, and creatinine levels.
- The logistic regression model showed substantial improvement over random selection (lift value of 3.33).
Conclusions:
- Identified key predictors of death in Ethiopian cardiac patients.
- Special attention should be directed towards elderly patients, those with prolonged surgical waiting times, and individuals with lower oxygen saturation, higher creatinine, lower ejection fraction, and lower hemoglobin levels.
- These findings can inform targeted interventions to reduce cardiovascular mortality in Ethiopia.
Introduction:
Cardiovascular diseases are a class of heart and blood vessel-related illnesses. In Sub-Saharan Africa, including Ethiopia, preventable heart disease continues to be a significant factor, contrasting with its presence in developed nations. Therefore, the objective of the study was to assess the prevalence of death due to cardiac disease and its risk factors among heart patients in Ethiopia.
Methods:
The current investigation included all cardiac patients who had cardiac surgery in the country between 2012 and 2023. A total of 1520 individuals were participated in the study. Data collection took place between February 2022 and January 2023. The study design was a retrospective cohort since the study track back patients' chart since 2012. Machine learning algorithms were applied for data analysis. For machine learning algorithms comparison, lift and AUC was applied.
Results:
From all possible algorithms, logistic algorithm at 90%/10% was the best fit since it produces the maximum AUC value. In addition, based on the lift value of 3.33, it can be concluded that the logistic regression algorithm was performing well and providing substantial improvement over random selection. From the logistic regression machine learning algorithms, age, saturated oxygen, ejection fraction, duration of cardiac center stays after surgery, waiting time to surgery, hemoglobin, and creatinine were significant predictors of death.
Conclusion:
Some of the predictors for the death of cardiac disease patients are identified as such special attention should be given to aged patients, for patients waiting for long periods of time to get surgery, lower saturated oxygen, higher creatinine value, lower ejection fraction and for patients with lower hemoglobin values.
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