Predicting 30-day survival after in-hospital cardiac arrest: a nationwide cohort study using machine learning and SHAP analysis.

Journal: BMJ open
PMID: 40288805

Abstract

OBJECTIVE: In-hospital cardiac arrest (IHCA) presents a critical challenge with low survival rates and limited prediction tools. Despite advances in resuscitation, predicting 30-day survival remains difficult, and current methods lack interpretability for timely decision-making. This study developed a machine learning (ML) model to predict 30-day survival after IHCA, using peri-arrest variables available on the rescue team's arrival, while ensuring a balance between predictive accuracy and clinical interpretability through Shapley Additive Explanations (SHAP).

Authors

  • Vibha Gupta
    Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Wallenberg Laboratory, Blå stråket 5, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden.
  • Aidin Rawshani
    Department of Molecular and Clinical Medicine, University of Gothenburg Institute of Medicine, Gothenburg, Sweden.
  • Peter Lundgren
    Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Wallenberg Laboratory, Blå stråket 5, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden; Department of Cardiology, Sahlgrenska University Hospital, Blå stråket 5, 413 45 Gothenburg, Sweden.
  • Mats Börjesson
    University of Gothenburg Institute of Medicine, Goteborg, Sweden.
  • Truls Ramunddal
    Department of Cardiology, Sahlgrenska universitetssjukhuset, Goteborg, Sweden.
  • Per Nordberg
    Department of Cardiology, Södersjukhuset, Stockholm, Sweden.
  • Therese Djärv
    Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
  • Johan Herlitz
    University of Gothenburg, Institute of Medicine, Sahlgrenska Academy, Gröna Stråket 4, 43146, Gothenburg, Sweden.
  • Joakim Sundström
    Department of Cardiology, Sahlgrenska University Hospital, Goteborg, Sweden.
  • Carl Magnusson
    PreHospen- Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, SE- 501 90, Sweden.
  • Antros Louca
    University of Gothenburg Institute of Medicine, Goteborg, Sweden.
  • Erik Andersson
    Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
  • Kristofer Skoglund
    Department of Molecular and Clinical Medicine, University of Gothenburg Institute of Medicine, Gothenburg, Sweden.
  • Araz Rawshani
    University of Gothenburg, Institute of Medicine, Sahlgrenska Academy, Gröna Stråket 4, 43146, Gothenburg, Sweden.

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