Deep learning model for the prediction of all-cause mortality among long term care people in China: a prospective cohort study.

Journal: Scientific reports
PMID:

Abstract

This study aimed to develop a deep learning model to predict the risk stratification of all-cause death for older people with disability, providing guidance for long-term care plans. Based on the government-led long-term care insurance program in a pilot city of China from 2017 and followed up to 2021, the study included 42,353 disabled adults aged over 65, with 25,071 assigned to the training set and 17,282 to the validation set. The administrative data (including baseline characteristics, underlying medical conditions, and all-cause mortality) were collected to develop a deep learning model by least absolute shrinkage and selection operator. After a median follow-up time of 14 months, 17,565 (41.5%) deaths were recorded. Thirty predictors were identified and included in the final models for disability-related deaths. Physical disability (mobility, incontinence, feeding), adverse events (pressure ulcers and falls from bed), and cancer were related to poor prognosis. A total of 10,127, 25,140 and 7086 individuals were classified into low-, medium-, and high-risk groups, with actual risk probabilities of death of 9.5%, 45.8%, and 85.5%, respectively. This deep learning model could facilitate the prevention of risk factors and provide guidance for long-term care model planning based on risk stratification.

Authors

  • Huai-Cheng Tan
    Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
  • Li-Jun Zeng
    Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, China.
  • Shu-Juan Yang
    West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
  • Li-Sha Hou
    National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, 610041, China.
  • Jin-Hui Wu
    National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, 610041, China.
  • Xin-Hui Cai
    Department of Mathematics and Statistics, University of North Carolina at Charlotte, Charlotte, NC, USA.
  • Fei Heng
    Department of Mathematics and Statistics, University of North Carolina at Charlotte, Charlotte, NC, USA.
  • Xu-Yu Gu
    School of Medicine, Southeast University, Nanjing, China.
  • Yue Zhong
    Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China.
  • Bi-Rong Dong
    National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, 610041, China.
  • Qing-Yu Dou
    National Clinical Research Center for Geriatrics, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, 610041, China. ddqqking@126.com.