Predicting Readmission of Cardiovascular Patients Admitted to the CCU using Data Mining Techniques

Marzie Salimi, P. Bastani, Mahdi Nasiri, Mehrdad Karajizadeh, R. Ravangard
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Abstract

Cardiovascular (CV) diseases account for a large number of readmissions. Using data mining techniques, we aimed to predict the readmission of CV patients to Coronary Care Units of 4 public hospitals in Shiraz, Iran, within 30 days after discharge. To identify the variables affecting the readmission of CV patients in the present cross-sectional study, a comprehensive review of previous studies and the consensus of specialists and sub-specialists were used. The obtained variables were based on 264 readmitted and non-readmitted patients. Readmission was modeled with predictive algorithms with an accuracy of >70% using the IBM SPSS Modeler 18.0 software. Cross-Industry Standard Process for Data Mining (CRISP-DM) methodology provided a structured approach to planning the project. Overall, 47 influential variables were included. The Support Vector Machine (SVM), Chi-square Automatic Interaction Detection (CHIAD), artificial neural network, C5.0, K-Nearest Neighbour, logistic regression, Classification and Regression (C&R) tree, and Quest algorithms with an accuracy of 98.60%, 89.60%, 89.90%, 88.00%, 85.90%, 79.90%, 78.60%, and 74.40%, respectively, were selected. The SVM algorithm was the best model for predicting readmission. According to this algorithm, the factors affecting readmission were age, arrhythmia, hypertension, chest pain, type of admission, cardiac or non-cardiac comorbidities, ejection fraction, undergoing coronary angiography, fluid and electrolyte disorders, and hospitalization 6-9 months before the current admission. According to the influential variables, it is suggested to educate patients, especially the older ones, about following physician advice and also to teach medical staff about up-to-date options to reduce readmissions.
利用数据挖掘技术预测入住重症监护室的心血管病人的再入院情况
心血管(CV)疾病造成了大量的再入院病例。 利用数据挖掘技术,我们旨在预测伊朗设拉子市 4 家公立医院冠心病监护病房的冠心病患者在出院后 30 天内的再入院情况。 在本横断面研究中,为了确定影响冠心病患者再入院的变量,我们全面回顾了之前的研究,并与专家和亚专家达成共识。获得的变量基于 264 名再次入院和未再次入院的患者。使用 IBM SPSS Modeler 18.0 软件,利用预测算法对再入院情况进行建模,准确率大于 70%。跨行业数据挖掘标准流程(CRISP-DM)方法为项目规划提供了结构化方法。 总体而言,共有 47 个有影响力的变量被纳入其中。支持向量机 (SVM)、奇偶自动交互检测 (CHIAD)、人工神经网络、C5.0、K-近邻、逻辑回归、分类与回归 (C&R) 树和 Quest 算法的准确率分别为 98.60%、89.60%、89.90%、88.00%、85.90%、79.90%、78.60% 和 74.40%。SVM 算法是预测再入院的最佳模型。根据该算法,影响再入院的因素包括年龄、心律失常、高血压、胸痛、入院类型、心脏病或非心脏病合并症、射血分数、接受冠状动脉造影术、液体和电解质紊乱以及本次入院前 6-9 个月的住院情况。 根据这些有影响的变量,建议教育患者(尤其是老年患者)听从医生的建议,并向医务人员传授减少再入院的最新方案。
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