Key result
An ensemble machine learning model predicted in-hospital mortality following perioperative cardiac arrest with an AUC of 0.90, identifying longer CPR and higher ASA physical status as top risk factors.
Why the study?
Perioperative cardiac arrest is associated with high mortality, motivating this study to investigate prognostic factors to mitigate risk through care management and planning.
Does a machine learning ensemble model accurately predict in-hospital mortality in patients with perioperative cardiac arrest?
Observational (n=150)
No
Does a machine learning ensemble model accurately predict in-hospital mortality in patients with perioperative cardiac arrest?
An ensemble machine learning model accurately predicted in-hospital mortality following perioperative cardiac arrest, identifying key risk factors and potentially aiding personalized care.
Answers are grounded in this paper and cite their sources.
May support risk stratification after perioperative arrest; leaves open prospective validation and outcome impact.
Perioperative cardiac arrest (POCA) is associated with a high mortality rate. This work aimed to study its prognostic factors for risk mitigation by means of care management and planning. A database of 380,919 surgeries was reviewed, and 150 POCAs were curated. The main outcome was mortality prior to hospital discharge. Patient demographic, medical history, and clinical characteristics (anesthesia and surgery) were the main features. Six machine learning (ML) algorithms, including LR, SVC, RF, GBM, AdaBoost, and VotingClassifier, were explored. The last algorithm was an ensemble of the first five algorithms. k-fold cross-validation and bootstrapping minimized the prediction bias and variance, respectively. Explainers (SHAP and LIME) were used to interpret the predictions. The ensemble provided the most accurate and robust predictions (AUC = 0.90 [95% CI, 0.78-0.98]) across various age groups. The risk factors were identified by order of importance. Surprisingly, the comorbidity of hypertension was found to have a protective effect on survival, which was reported by a recent study for the first time to our knowledge. The validated ensemble classifier in aid of the explainers improved the predictive differentiation, thereby deepening our understanding of POCA prognostication. It offers a holistic model-based approach for personalized anesthesia and surgical treatment.
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Shang et al. (2022) conducted an observational in Perioperative cardiac arrest (n=150). Risk factors for mortality (e.g., CPR duration, ASA physical status) vs. Patients without the specific risk factors was evaluated on In-hospital mortality prior to discharge (AUC 0.90, 95% CI 0.78-0.98). An ensemble machine learning model predicted in-hospital mortality following perioperative cardiac arrest with an AUC of 0.90, identifying longer CPR and higher ASA physical status as top risk factors.
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