doiSerbia

Data mining approach for in-hospital treatment outcome in patients with acute coronary syndrome

Sladojević Miroslava (Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica)
Čanković Milenko (Faculty of Medicine, Novi Sad)
Čemerlić Snežana (Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica)
Mihajlović Bojan (Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica)
Ađić Filip (Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica)
Jaraković Milana (Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica)

Introduction. Risk stratification is nowadays crucial when estimating the patient’s prognosis in terms of treatment outcome and it also helps in clinical decision making. Several risk assessment models have been developed to predict short-term outcomes in patients with acute coronary syndrome. This study was aimed at developing an outcome prediction model for patients with acute coronary syndrome submitted to percutaneus coronary intervention using data mining approach. Material and Methods. A total of 2030 patients hospitalized for acute coronary syndrome and treated with percutaneous coronary intervention from December 2008 to December 2011 were assigned to a derivation cohort. Demographic and anamnestic data, clinical characteristics on admission, biochemical analysis of blood parameters on admission, and left ventricular ejection fraction formed the basis of the study. A number of machine learning algorithms available within Waikato Environment for Knowledge Discovery had been evaluated and the most successful was chosen. The predictive model was subsequently validated in a different population of 931 patients (validation cohort), hospitalized during 2012. Results. The best prediction results were achieved using Alternating Decision Tree classifier, which was able to predict in-hospital mortality with 89% accuracy, and preserved good performance on validation cohort with 87% accuracy. Alternating Decision Tree classifier identified a subset of 6 attributes most relevant to mortality prediction: systolic and diastolic blood pressure, heart rate, left ventricular ejection fraction, age, and troponin value. Conclusion. Data mining approach enabled the authors to develop a model capable of predicting the in-hospital outcome following percutaneous coronary intervention. The model showed excellent sensitivity and specificity during internal validation.

Keywords: Data Mining, Treatment Outcome, Acute Coronary Syndrome, Risk Assessment, Mortality