International Journal of General Medicine (Jul 2024)

Comparative Analysis of Heart Failure with Preserved Vs Reduced Ejection Fraction: Patient Characteristics, Outcomes, Mortality Prediction, and Machine Learning Model Development in the JoHFR

  • Izraiq M,
  • AlBalbissi K,
  • Alawaisheh R,
  • Toubasi A,
  • Ahmed YB,
  • Mahmoud M,
  • Khraim KI,
  • AL-Ithawi M,
  • Mansour OM,
  • Hamati A,
  • Khraisat FA,
  • Abu-Hantash H

Journal volume & issue
Vol. Volume 17
pp. 3083 – 3091

Abstract

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Mahmoud Izraiq,1 Kais AlBalbissi,2 Raed Alawaisheh,1 Ahmad Toubasi,2 Yaman B Ahmed,3 Marah Mahmoud,1 Karam I Khraim,1 Mohammed AL-Ithawi,1 Obada Mohammad Mansour,1 Anoud Hamati,1 Farah A Khraisat,2 Hadi Abu-Hantash4 1Cardiology Section, Internal Medicine Department, Specialty Hospital, Amman, Jordan; 2Cardiology Section, Internal Medicine Department, Jordan University Hospital, Amman, Jordan; 3Cardiology Section, Internal Medicine Department, King Abdullah University Hospital, Irbid, Jordan; 4Department of Cardiology, Amman Surgical Hospital, Amman, JordanCorrespondence: Mahmoud Izraiq, Email [email protected]: Heart failure (HF) is a global health challenge affecting millions, with significant variations in patient characteristics and outcomes based on ejection fraction. This study aimed to differentiate between HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) with respect to patient characteristics, risk factors, comorbidities, and clinical outcomes, incorporating advanced machine learning models for mortality prediction.Methodology: The study included 1861 HF patients from 21 centers in Jordan, categorized into HFrEF (EF < 40%) and HFpEF (EF ≥ 50%) groups. Data were collected from 2021 to 2023, and machine learning models were employed for mortality prediction.Results: Among the participants, 29.7% had HFpEF and 70.3% HFrEF. Significant differences were noted in demographics and comorbidities, with a higher prevalence of males, younger age, smoking, and familial history of premature ASCVD in the HFrEF group. HFpEF patients were typically older, with higher rates of diabetes, hypertension, and obesity. Machine learning analysis, mainly using the Random Forest Classifier, demonstrated significant predictive capability for mortality with an accuracy of 0.9002 and an AUC of 0.7556. Other models, including Logistic Regression, SVM, and XGBoost, also showed promising results. Length of hospital stay, need for mechanical ventilation, and number of hospital admissions were the top predictors of mortality in our study.Conclusion: The study underscores the heterogeneity in patient profiles between HFrEF and HFpEF. Integrating machine learning models offers valuable insights into mortality risk prediction in HF patients, highlighting the potential of advanced analytics in improving patient care and outcomes.Keywords: Heart failure, mortality prediction, machine learning, patient outcomes, Jordan heart failure registry

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