Back to Journals » International Journal of General Medicine » Volume 13

Predicting Postoperative Length of Stay for Isolated Coronary Artery Bypass Graft Patients Using Machine Learning

Authors Alshakhs F, Alharthi H, Aslam N, Khan IU, Elasheri M

Received 18 February 2020

Accepted for publication 10 August 2020

Published 2 October 2020 Volume 2020:13 Pages 751—762

DOI https://doi.org/10.2147/IJGM.S250334

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Fatima Alshakhs,1 Hana Alharthi,1 Nida Aslam,2 Irfan Ullah Khan,2 Mohamed Elasheri3

1Department of Health Information Management & Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam 34221-4237, Saudi Arabia; 2Department of Computer Science, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, Dammam 34221-4237, Saudi Arabia; 3Department of Cardiac Surgery, Saud Albabtain Cardiac Centre, Dammam 32245, Saudi Arabia

Correspondence: Fatima Alshakhs
Imam Abdulrahman Bin Faisal University, College of Public Health, Health Information Management and Technology (HIMT), Dammam 34212, Saudi Arabia
Tel +966 13 333 1309
Email falshakhs@iau.edu.sa

Purpose: Predictive analytics (PA) is a new trending approach in the field of healthcare that uses machine learning to build a prediction model using supervised learning algorithms. Isolated coronary artery bypass grafting (iCABG), an open-heart surgery, is commonly performed in the treatment of coronary heart disease.
Aim: The aim of this study was to develop and evaluate a model to predict postoperative length of stay (PLoS) for iCABG patients using supervised machine learning techniques, and to identify the features with the highest contribution to the model.
Methods: This is a retrospective study that uses historic data of adult patients who underwent isolated CABG (iCABG). After initial data pre-processing, data imputation using the kNN method was applied. The study used five prediction models using Naïve Bayes, Decision Tree, Random Forest, Logistic Regression and k Nearest Neighbor algorithms. Data imbalance was managed using the following widely used methods: oversampling, undersampling, “Both”, and random over-sampling examples (ROSE). The features selection process was conducted using the Boruta method. Two techniques were applied to examine the performance of the models, (70%, 30%) split and cross-validation, respectively. Models were evaluated by comparing their performance using AUC and other metrics.
Results: In the final dataset, six distinct features and 621 instances were used to develop the models. A total of 20 models were developed using R statistical software. The model generated using Random Forest with “Both” resampling method and cross-validation technique was deemed the best fit (AUC=0.81; F1 score=0.82; and recall=0.82). Attributes found to be highly predictive of PLoS were pulmonary artery systolic, age, height, EuroScore II, intra-aortic balloon pump used, and complications during operation.
Conclusion: This study demonstrates the significance and effectiveness of building a model that predicts PLoS for iCABG patients using patient specifications and pre-/intra-operative measures.

Keywords: predictive analytics, classifiers, CABG, LoS

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]