Generative AI-powered explainable prediction model: Enhancing early in-hospital mortality alert for patients with...

Early identification of patients with acute myocardial infarction (AMI) at high risk of in-hospital mortality is crucial for optimizing treatment strategies. However, the urgent nature of these clinical scenarios often limits the ability to gather the comprehensive data necessary for accurate risk assessment. Missing data presents a substantial challenge to timely and effective risk evaluation METHODS: We developed MortiGen, an end-to-end model designed to address the dual challenges of missing data imputation and mortality risk prediction in patients with AMI. The model was trained using data from 9163 admissions in the eICU collaborative research database and externally tested on 12,166 admissions from the medical information Mart for intensive care and 2142 admissions from the Chongqing University central hospital. The performance of the MortiGen was compared with other ten models using multiple evaluation metrics RESULTS: MortiGen demonstrated robust performance in predicting in-hospital mortality using data available at 3 h, 12 h, 24 h, and throughout the entire hospital stay (ranging from 47.2 % to 89.5 % of the data available), with receiver operating characteristic curve ranging from 0.794 to 0.855. MortiGen outperformed other ten models. Notably, when relying solely on data available within the first 3 h of admission, MortiGen achieving performance better than some comparison models, which used data from the entire hospitalization CONCLUSIONS: MortiGen effectively predicts in-hospital mortality among patients with AMI, even in the early stages of hospital admission, overcoming challenges related to limited data availability due to time constraints and variability in laboratory testing conditions.