Deep learning for predicting in-hospital mortality among heart disease patients based on echocardiography.

Abstract

Heart disease (HD) is the leading cause of global death; there are several mortality prediction models of HD for identifying critically-ill patients and for guiding decision making. The existing models, however, cannot be used during initial treatment or screening. This study aimed to derive and validate an echocardiography-based mortality prediction model for HD using deep learning (DL). In this multicenter retrospective cohort study, the subjects were admitted adult (age≥18years) HD patients who underwent echocardiography. The outcome was in-hospital mortality. We extracted predictor variables from echocardiography reports using text mining. We developed deep learning-based prediction model using derivation data of a hospital A. And we conducted external validation using echocardiography report of hospital B. We conducted subgroup analysis of coronary heart disease (CHD) and heart failure (HF) patients of hospital B and compared DL with the currently used predictive models (eg, Global Registry of Acute Coronary Events (GRACE) score, Thrombolysis in Myocardial Infarction score (TIMI), Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score, and Get With The Guidelines-Heart Failure (GWTG-HF) score). The study subjects comprised 25776 patients with 1026 mortalities. The areas under the receiver operating characteristic curve (AUROC) of the DL model were 0.912, 0.898, 0.958, and 0.913 for internal validation, external validation, CHD, and HF, respectively, and these results significantly outperformed other comparison models. This echocardiography-based deep learning model predicted in-hospital mortality among HD patients more accurately than existing prediction models and other machine learning models.