Mortality predicting models for patients with infective endocarditis: a machine learning approach.

backgroundInfective endocarditis (IE) is a fatal cardiovascular disease with varied clinical manifestations but rapid progression. A series of existing risk models helped identify IE patients with high risk, but the imperfect predictive performance and limited application called for better predictive systems.

methodsThe single-centered, retrospective observational study applied four machine learning methods for predictive model construction: LASSO logistic regression, random forest (RF), support vector machine (SVM), and k-nearest neighbors (KNN). A 10-fold cross-validated area under the receiver operating characteristic curve (AUC-ROC) was used for performance evaluation.

resultsA total of 1705 patients with IE were enrolled in the study, with 119 in-hospital deaths and 178 deaths after 6-month follow-up. RF achieved the highest AUC-ROCs for in-hospital and six-month mortality prediction (in-hospital: 0.83, 6-month: 0.85). RF was also applied to assess variable importance. The following variables were selected by RF as top important predictors for both in-hospital and six-month mortality prediction: total bilirubin, N-terminal pro-B-type natriuretic peptide, albumin, diastolic blood pressure, fasting blood glucose, uric acid, and age.

conclusionsA risk model with machine learning approach was integrated in purpose of prognosis prediction in IE patients, helping rapid risk stratification and in-time management clinically. CLINICAL TRIAL NUMBER: Not applicable.