Factors associated with 90-day mortality in Vietnamese stroke patients: Prospective findings compared with explainable machine learning, multicenter study.

Autor: Mai TD; Faculty of Stroke and Cerebrovascular Disease, University of Medicine and Pharmacy, Vietnam National University, Ho Chi Minh City, Vietnam.; Stroke Center, Bach Mai Hospital, Hanoi, Vietnam.; Hanoi Medical University, Hanoi, Vietnam., Nguyen DT; Faculty of Stroke and Cerebrovascular Disease, University of Medicine and Pharmacy, Vietnam National University, Ho Chi Minh City, Vietnam.; Stroke Center, Bach Mai Hospital, Hanoi, Vietnam., Tran CC; Stroke International Services (S.I.S) General Hospital, Can Tho City, Vietnam., Duong HQ; Da Nang Hospital, Da Nang City, Vietnam., Nguyen HN; Nghe An Friendship General Hospital, Vinh City, Vietnam., Dang DP; Military Medical Academy, Hanoi, Vietnam., Hoang HB; Hanoi Medical University, Hanoi, Vietnam.; Hanoi Medical University Hospital, Hanoi, Vietnam., Vo HK; Hanoi Medical University, Hanoi, Vietnam.; Department of Neurology, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam.; Center of Neurology, Hanoi, Vietnam., Pham TQ; Stroke Center, Bach Mai Hospital, Hanoi, Vietnam., Truong HT; Faculty of Stroke and Cerebrovascular Disease, University of Medicine and Pharmacy, Vietnam National University, Ho Chi Minh City, Vietnam., Tran MC; Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom., Dao PV; Faculty of Stroke and Cerebrovascular Disease, University of Medicine and Pharmacy, Vietnam National University, Ho Chi Minh City, Vietnam.; Stroke Center, Bach Mai Hospital, Hanoi, Vietnam.; Hanoi Medical University, Hanoi, Vietnam.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Sep 20; Vol. 19 (9), pp. e0310522. Date of Electronic Publication: 2024 Sep 20 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0310522
Abstrakt: The prevalence and predictors of mortality following an ischemic stroke or intracerebral hemorrhage have not been well established among patients in Vietnam. 2885 consecutive diagnosed patients with ischemic stroke and intracerebral hemorrhage at ten stroke centres across Vietnam were involved in this prospective study. Posthoc analyses were performed in 2209 subjects (age was 65.4 ± 13.7 years, with 61.4% being male) to explore the clinical characteristics and prognostic factors associated with 90-day mortality following treatment. An explainable machine learning model using extreme gradient boosting and SHapley Additive exPlanations revealed the correlation between original clinical research and advanced machine learning methods in stroke care. In the 90 days following treatment, the mortality rate for ischemic stroke was 8.2%, while for intracerebral hemorrhage, it was higher at 20.5%. Atrial fibrillation was an elevated risk of 90-day mortality in the ischemic stroke patient (OR 3.09; 95% CI 1.90-5.02, p<0.001). Among patients with intracerebral hemorrhage, there was no statistical significance in those with hypertension compared to their counterparts without hypertension (OR 0.65, 95% CI 0.41-1.03, p > 0.05). The baseline NIHSS score was a significant predictor of 90-day mortality in both patient groups. The machine learning model can predict a 0.91 accuracy prediction of death rate after 90 days. Age and NIHSS score were in the top high risks with other features, such as consciousness, heart rate, and white blood cells. Stroke severity, as measured by the NIHSS, was identified as a predictor of mortality at discharge and the 90-day mark in both patient groups.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Mai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje