Machine learning-based model to predict composite thromboembolic events among Chinese elderly patients with atrial fibrillation

作者：Jiefeng Ren, Haijun Wang, Lai Song, Yi Shao, Hebin Che, Zaiyao Xue, Xinlian Qi, Sha Zhang, Jinkun Dai, Sai Wang, Kunlian Li, Wei Gan, Quanjin Si · 发表于：BMC Cardiovascular Disorders · 年份：2024 · DOI：10.1186/s12872-024-04082-9 · 被引用次数：8 · 研究领域：Atrial Fibrillation Management and Outcomes、Acute Ischemic Stroke Management、Venous Thromboembolism Diagnosis and Management

OBJECTIVE: Accurate prediction of survival prognosis is helpful to guide clinical decision-making. The aim of this study was to develop a model using machine learning techniques to predict the occurrence of composite thromboembolic events (CTEs) in elderly patients with atrial fibrillation(AF). These events encompass newly diagnosed cerebral ischemia events, cardiovascular events, pulmonary embolism, and lower extremity arterial embolism. METHODS: This retrospective study included 6,079 elderly hospitalized patients (≥ 75 years old) with AF admitted to the People's Liberation Army General Hospital in China from January 2010 to June 2022. Random forest imputation was used for handling missing data. In the descriptive statistics section, patients were divided into two groups based on the occurrence of CTEs, and differences between the two groups were analyzed using chi-square tests for categorical variables and rank-sum tests for continuous variables. In the machine learning section, the patients were randomly divided into a training dataset (n = 4,225) and a validation dataset (n = 1,824) in a 7:3 ratio. Four machine learning models (logistic regression, decision tree, random forest, XGBoost) were trained on the training dataset and validated on the validation dataset. RESULTS: The incidence of composite thromboembolic events was 19.53%. The Least Absolute Shrinkage and Selection Operator (LASSO) method, using 5-fold cross-validation, was applied to the training dataset and id...