Machine learning for the prediction of in-hospital mortality in patients with spontaneous intracerebral hemorrhage in intensive care unit.

Journal: Scientific reports
Published Date:

Abstract

This study aimed to develop a machine learning (ML)-based tool for early and accurate prediction of in-hospital mortality risk in patients with spontaneous intracerebral hemorrhage (sICH) in the intensive care unit (ICU). We did a retrospective study in our study and identified cases of sICH from the MIMIC IV (n = 1486) and Zhejiang Hospital databases (n = 110). The model was constructed using features selected through LASSO regression. Among five well-known models, the selection of the best model was based on the area under the curve (AUC) in the validation cohort. We further analyzed calibration and decision curves to assess prediction results and visualized the impact of each variable on the model through SHapley Additive exPlanations. To facilitate accessibility, we also created a visual online calculation page for the model. The XGBoost exhibited high accuracy in both internal validation (AUC = 0.907) and external validation (AUC = 0.787) sets. Calibration curve and decision curve analyses showed that the model had no significant bias as well as being useful for supporting clinical decisions. XGBoost is an effective algorithm for predicting in-hospital mortality in patients with sICH, indicating its potential significance in the development of early warning systems.

Authors

  • Baojie Mao
    Brain center, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, 1229 Gudun Road, Hangzhou, 310030, China.
  • Lichao Ling
    Brain center, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, 1229 Gudun Road, Hangzhou, 310030, China.
  • Yuhang Pan
    Urology Department, Lin'an Hospital of Traditional Chinese Medicine, Hangzhou, 311321, China.
  • Rui Zhang
    Department of Cardiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China.
  • Wanning Zheng
    Brain center, Zhejiang Hospital, Hangzhou, China.
  • Yanfei Shen
    Department of Intensive Care, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Hangzhou, 310030, China.
  • Wei Lu
    Department of Pharmacy, Taihe Hospital, Hubei University of Medicine, Shiyan, China.
  • Yuning Lu
    Brain center, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, 1229 Gudun Road, Hangzhou, 310030, China.
  • Shanhu Xu
    Brain center, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, 1229 Gudun Road, Hangzhou, 310030, China.
  • Jiong Wu
    Brain center, Zhejiang Hospital, Hangzhou, China.
  • Ming Wang
    Brain center, Zhejiang Hospital, Hangzhou, China.
  • Shu Wan
    Brain center, Zhejiang Hospital, Hangzhou, China.