| Title | Machine Learning-Based Personalized Risk Prediction Model for Mortality of Patients Undergoing Mitral Valve Surgery: The PRIME Score |
| Authors | Zhou, Ning Ji, Zhili Li, Fengjuan Qiao, Bokang Lin, Rui Jiang, Wenxi Zhu, Yuexin Lin, Yuwei Zhang, Kui Li, Shuanglei You, Bin Gao, Pei Dong, Ran Wang, Yuan Du, Jie |
| Affiliation | Capital Med Univ, Beijing Anzhen Hosp, Beijing, Peoples R China Capital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart, Lung & Blood Vessel Dis, Beijing, Peoples R China Capital Med Univ, Beijing Anzhen Hosp, Dept Cardiac Surg, Beijing, Peoples R China Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing, Peoples R China Chinese Peoples Liberat Army Gen Hosp, Dept Cardiac Surg, Beijing, Peoples R China Peking Univ Hlth Sci Ctr, Peking Univ, Beijing, Peoples R China Peking Univ, Key Lab Mol Cardiovasc Sci, Minist Educ, Beijing, Peoples R China |
| Keywords | VALVULAR HEART-DISEASE ECHOCARDIOGRAPHIC PREDICTION REPLACEMENT ASSOCIATION MANAGEMENT SOCIETY ANEMIA SYSTEM FUTURE ESC |
| Issue Date | 1-Apr-2022 |
| Publisher | FRONTIERS IN CARDIOVASCULAR MEDICINE |
| Abstract | Background: Mitral valve surgery (MVS) is an effective treatment for mitral valve diseases. There is a lack of reliable personalized risk prediction models for mortality in patients undergoing mitral valve surgery. Our aim was to develop a risk stratification system to predict all-cause mortality in patients after mitral valve surgery.& nbsp;Methods: Different machine learning models for the prediction of all-cause mortality were trained on a derivation cohort of 1,883 patients undergoing mitral valve surgery [split into a training cohort (70%) and internal validation cohort (30%)] to predict all-cause mortality. Forty-five clinical variables routinely evaluated at discharge were used to train the models. The best performance model (PRIME score) was tested in an externally validated cohort of 220 patients undergoing mitral valve surgery. The model performance was evaluated according to the area under the curve (AUC). Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were compared with existing risk strategies.& nbsp;Results: After a median follow-up of 2 years, there were 133 (7.063%) deaths in the derivation cohort and 17 (7.727%) deaths in the validation cohort. The PRIME score showed an AUC of 0.902 (95% confidence interval [CI], 0.849-0.956) in the internal validation cohort and 0.873 (95% CI: 0.769-0.977) in the external validation cohort. In the external validation cohort, the performance of the PRIME score was significantly improved compared with that of the existing EuroSCORE II (NRI = 0.550, [95% CI 0.001-1.099], P = 0.049, IDI = 0.485, [95% CI 0.230-0.741], P < 0.001).& nbsp;Conclusion: Machine learning-based model (the PRIME score) that integrate clinical, demographic, imaging, and laboratory features demonstrated superior performance for the prediction of mortality patients after mitral valve surgery compared with the traditional risk model EuroSCORE II. |
| URI | http://hdl.handle.net/20.500.11897/643031 |
| ISSN | 2297-055X |
| DOI | 10.3389/fcvm.2022.866257 |
| Indexed | SCI(E) |
| Appears in Collections: | 公共卫生学院 分子心血管学教育部重点实验室 |
