Development of a risk score for predicting one-year mortality in patients with atrial fibrillation using XGBoost-assisted feature selection.

Kardiol Pol

Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.

Published: November 2024

AI Article Synopsis

  • A study was conducted to create a tool for predicting 1-year mortality risk in patients with atrial fibrillation (AF) by using machine learning methods.
  • Utilizing data from the MIMIC-IV database and validated with an external dataset, the CRAMB score was developed, which includes key variables like age and comorbidities.
  • The CRAMB score showed better predictive ability compared to existing scores, making it a simple and effective option for assessing mortality risk in a diverse AF patient population.

Article Abstract

Background: There are no tools specifically designed to assess mortality risk in patients with atrial fibrillation (AF).

Aims: This study aimed to utilize machine learning methods to identify pertinent variables and develop an easily applicable prognostic score to predict 1-year mortality in AF patients.

Methods: This study, based on the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database, focused on patients aged 18 years and older with AF. A critical care database from China was the external validation set. The importance of variables from XGBoost guided the development of a logistic model, forming the basis for an AF scoring model.

Results: Records of of 26 365 AF patients were obtained from the MIMIC-IV database. The external validation dataset included 231 AF patients. The CRAMB score (Charlson comorbidity index, readmission, age, metastatic solid tumor, and maximum blood urea nitrogen concentration) outperformed the CCI and CHA2DS2-VASc scores, demonstrating superior predictive value for 1-year mortality. In the test set, the area under the receiver operating characteristic (AUC) for the CRAMB score was 0.765 (95% confidence interval [CI], 0.753-0.776), while in the external validation set, it was 0.582 (95% CI, 0.502-0.657).

Conclusions: The simplicity of the CRAMB score makes it user-friendly, allowing for coverage of a broader and more heterogeneous AF population.

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Source
http://dx.doi.org/10.33963/v.phj.101842DOI Listing

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