基于随机生存森林的慢性心力衰竭的老年患者的预后预测
Xuewu Song1, Yuan Bian1, Changyu Zhu1
1Department of Pharmacy, Personalized Drug Research and Therapy Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Frontiers in cardiovascular medicine
|September 22, 2025
概括
一个新的随机生存森林 (RSF) 模型有效预测慢性心力衰竭 (CHF) 的老年患者的预后,优于传统指标. 该工具有助于识别高风险个体,以便更好地管理.
科学领域:
- 心脏病学 心脏病学
- 生物统计学 生物统计学
- 老年病的医生 老年病的医生
背景情况:
- 慢性心力衰竭 (CHF) 的老年患者缺乏足够的预后评估工具.
- 准确的风险分层对于管理这种脆弱人群至关重要.
研究的目的:
- 开发和验证一种随机生存森林 (RSF) 模型,用于预测老年CHF患者的预后.
- 将RSF模型的性能与已建立的临床指标进行比较.
主要方法:
- 一组525名老年CHF患者被分为训练 (70%) 和测试 (30%) 组.
- 开发了一个随机生存森林 (RSF) 模型来预测全因死亡率和复合终点 (再录取+死亡率).
- 模型性能使用Harrell的C指数,决策曲线分析 (DCA) 和校准曲线进行评估,将RSF与NYHA类,LVEF和BNP水平进行比较.
主要成果:
- 在RSF模型中,所有死因的C指数为0.747 (培训) 和0.714 (测试).
- 对于复合终点,RSF模型实现了0.707 (培训) 和0.641 (测试) 的C指数.
- 决策曲线分析和校准曲线表明RSF模型具有良好的临床实用性和准确性.
结论:
- 开发的RSF模型在老年CHF患者的预后方面表现出强大的预测性能.
- 该RSF模型表现出良好的区分,临床实用性和校准.
- 该模型为识别高风险老年CHF患者提供了有价值的工具.
相关概念视频
01:30Heart Failure IV: Classification and Diagnostic Evaluation
323
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
323
01:19Survival Tree
389
Survival trees are a non-parametric method used in survival analysis to model the relationship between a set of covariates and the time until an event of interest occurs, often referred to as the "time-to-event" or "survival time." This method is particularly useful when dealing with censored data, where the event has not occurred for some individuals by the end of the study period, or when the exact time of the event is unknown.
Building a Survival Tree
Constructing a...
Building a Survival Tree
Constructing a...
389
01:17Pathophysiology of Heart Failure
3.0K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
3.0K
01:30Heart Failure VII: Nursing Interventions
422
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
422
01:20Comparing the Survival Analysis of Two or More Groups
561
Survival analysis is a cornerstone of medical research, used to evaluate the time until an event of interest occurs, such as death, disease recurrence, or recovery. Unlike standard statistical methods, survival analysis is particularly adept at handling censored data—instances where the event has not occurred for some participants by the end of the study or remains unobserved. To address these unique challenges, specialized techniques like the Kaplan-Meier estimator, log-rank test, and...
561
01:30Heart Failure V: Medical Management
223
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
223