Abstract

Background: Diagnosing patient deterioration and preventing unexpected deaths in the emergency department is a complex task that relies on the expertise and comprehensive understanding of emergency physicians concerning extensive clinical data. Objectives: Our study aimed to predict emergency department mortality and compare different models. Methods: During a one-month period, demographic information and records were collected from 1,000 patients admitted to the emergency department of a selected hospital in Tehran. We rigorously followed The Cross Industry Standard Process for data mining and methodically progressed through its sequential steps. We employed Cat Boost and Random Forest models for prediction purposes. To prevent overfitting, Random Forest feature selection was employed. Expert judgment was utilized to eliminate features with an importance score below 0.0095. To achieve a more thorough and dependable assessment, we implemented a K-fold cross-validation method with a value of 5. Results: The Cat Boost model outperformed Random Forest significantly, showcasing an impressive mean accuracy of 0.94 (standard deviation: 0.03). Ejection fraction, urea (body waste materials), and diabetes had the greatest impact on prediction. Conclusions: This study sheds light on the exceptional accuracy and efficiency of machine learning in predicting emergency department mortality, surpassing the performance of traditional models. Implementing such models can result in significant improvements in early diagnosis and intervention. This, in turn, allows for optimal resource allocation in the emergency department, preventing the excessive consumption of resources and ultimately saving lives while enhancing patient outcomes.

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