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Machine Learning Models Incorporating Nursing Care Needs to Predict 180-Day Prognosis in Patients With Heart Failure:

Takuya Nishino¹, Katsuhito Kato², Shuhei Tara³

¹Department of Health Policy and Management, Nippon Medical School Tokyo Japan.

Circulation Reports

|May 11, 2026

Summary

Machine learning models accurately predict heart failure (HF) patient prognosis within 180 days. Incorporating nursing care needs significantly improves these predictions, aiding community-based HF management and reducing hospital readmissions.

Keywords:

Community Mortality Multidimensional Nursing Rehospitalization

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Area of Science:

Cardiology
Health Informatics
Machine Learning in Healthcare

Background:

Increasing heart failure (HF) prevalence necessitates improved community-based care and readmission reduction strategies.
Current prognostic models lack integration of structured, multidimensional patient assessments.
Predicting medium-term prognosis is crucial for effective post-discharge HF management.

Purpose of the Study:

To develop and validate machine learning (ML) models for predicting 180-day mortality or emergency hospitalization in HF patients.
To assess the impact of incorporating nursing care needs into prognostic models.
To identify key prognostic factors in HF patients.

Main Methods:

Multicenter study involving 4,904 HF patients, randomly split into training (80%) and validation (20%) sets.
Development and validation of logistic regression, random forest, extreme gradient boosting, and light gradient boosting ML models.
Inclusion of nursing care needs, derived from structured assessments, as a predictive feature alongside established variables.

Main Results:

All developed ML models demonstrated acceptable discriminative performance (Area Under Precision-Recall Curve) and calibration (Calibration Slope, Brier Score).
Effective risk stratification was achieved for HF patients.
Shapley Additive Explanations identified nursing care needs as a significant prognostic factor.

Conclusions:

ML models integrating nursing care needs accurately predict 180-day prognosis in HF patients.
Nursing care needs are a valuable addition to prognostic modeling, highlighting the importance of structured, multidimensional data.
Emphasizes the value of team-based post-discharge HF management.