A stacking-based model for predicting 30-day all-cause hospital readmissions of patients with acute myocardial infarction

Abstract

BACKGROUND: Acute myocardial infarction (AMI) is a serious cardiovascular disease, followed by a high readmission rate within 30-days of discharge. Accurate prediction of AMI readmission is a crucial way to identify the high-risk group and optimize the distribution of medical resources. METHODS: In this study, we propose a stacking-based model to predict the risk of 30-day unplanned all-cause hospital readmissions for AMI patients based on clinical data. Firstly, we conducted an under-sampling method of neighborhood cleaning rule (NCR) to alleviate the class imbalance and then utilized a feature selection method of SelectFromModel (SFM) to select effective features. Secondly, we adopted a self-adaptive approach to select base classifiers from eight candidate models according to their performances in datasets. Finally, we constructed a three-layer stacking model in which layer 1 and layer 2 were base-layer and level 3 was meta-layer. The predictions of the base-layer were used to train the meta-layer in order to make the final forecast. RESULTS: The results show that the proposed model exhibits the highest AUC (0.720), which is higher than that of decision tree (0.681), support vector machine (0.707), random forest (0.701), extra trees (0.709), adaBoost (0.702), bootstrap aggregating (0.704), gradient boosting decision tree (0.710) and extreme gradient enhancement (0.713). CONCLUSION: It is evident that our model could effectively predict the risk of 30-day all cause hospital readmissions for AMI patients and provide decision support for the administration.

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