埃塞俄比亚心脏病患者的术后生存率和相关因素:机器学习,半参数和参数建模的应用
Melaku Tadege1,2,3, Awoke Seyoum Tegegne4, Zelalem G Dessie4,5
1College of Science, Bahir Dar University, Bahir Dar, Ethiopia. melakutadege@yahoo.com.
BMC medical informatics and decision making
|March 30, 2024
概括
埃塞俄比亚的心血管疾病生存率受到长时间的手术等待时间和患者年龄的影响. 改善心脏护理的准入对于心脏手术后更好的患者结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 医疗信息学 医疗信息学
背景情况:
- 心血管疾病 (CVD) 是撒哈拉以南非洲,特别是埃塞俄比亚可预防死亡的主要原因.
- 埃塞俄比亚面临着大量心脏手术患者的积压,大约有4万名患者正在等待手术.
- 关于埃塞俄比亚心脏手术后患者的长期存活情况的数据有限.
研究的目的:
- 确定埃塞俄比亚心脏手术后患者的长期生存状态.
- 确定这一患者群体中死亡率的关键预测因素.
主要方法:
- 一项回顾性研究,包括1520名心脏病患者从2012-2023.
- 机器学习算法的应用,特别是随机生存森林.
- 珀茨回归用于对生存预测因子的多变量分析.
主要成果:
- 临床预测的关键预测因素包括氧和度 (SPO2),年龄,手术等待时间和肌水平.
- 较低的SPO2,较高的年龄,较低的射出分数和较长的等待时间是死亡率的重要预测因素.
- 随机生存森林确定了SPO2 (42.55%) 和年龄 (25.17%) 作为影响最大的变量.
结论:
- 长时间的等待时间和晚年是心脏手术后死亡率的关键风险因素.
- 埃塞俄比亚有限的心脏中心数量 (两个) 对其人口来说不足.
- 建议包括增加心脏手术中心的数量,以改善患者的准入和结果.
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