基于树的生存分析改善了心脏手术中的死亡率预测
Jahan C Penny-Dimri1, Christoph Bergmeir2,3, Christopher M Reid1,4
1Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia.
Frontiers in cardiovascular medicine
|July 26, 2023
概括
机器学习生存分析准确预测心脏手术死亡率. 梯度增强机器的性能优于考克斯模型,识别了改善患者结果的关键风险因素,如年龄和手术类型.
科学领域:
- 心血管外科心血管外科
- 医疗信息学 医疗信息学
- 机器学习 机器学习
背景情况:
- 机器学习分类工具是为了预测心脏手术结果而建立的.
- 基于ML的生存分析是预测心脏手术后死亡率的未经探索的方法.
研究的目的:
- 为了比较基于树的生存模型与Cox比例危险 (CPH) 建模的性能,以预测心脏手术死亡率.
- 通过使用表现最佳的ML模型,识别死亡的关键风险因素.
主要方法:
- 利用了144,536名患者 (147,301次手术事件) 的全国数据库.
- 通过双重交叉验证,比较了三个ML模型:决策树 (DT),随机森林 (RF) 和梯度增强机 (GBM).
- 使用一致性指数 (C指数) 评估性能.
主要成果:
- 梯度提升机 (GBM) 获得了最高的C指数 (0.803),超过了随机森林 (0.791),决策树 (0.729) 和考克斯比例危险 (0.596).
- 死亡率的首要预测因素包括年龄,手术类型,住院时间,早期手术后排气量和异能药物使用时间.
结论:
- 基于树的生存分析为传统的CPH建模提供了一个非参数和高性能替代方案.
- GBM提供了对非线性关系的可解释的见解,突出了关键的风险因素,并指导了未来的心脏手术研究.
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