Predicting Mortality in Subarachnoid Hemorrhage Patients Using Big Data and Machine Learning: A Nationwide Study in Türkiye

Background/Objective: Subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality rates, necessitating prognostic algorithms to guide decisions. Our study evaluates the use of machine learning (ML) models for predicting 1-month and 1-year mortality among SAH patients using national...

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Main Authors: Khaniyev, Taghi, Cekic, Efecan, Gecici, Neslihan Nisa, Can, Sinem, Ata, Naim, Ulgu, Mustafa Mahir, Birinci, Suayip, Isikay, Ahmet Ilkay, Bakir, Abdurrahman, Arat, Anil, Hanalioglu, Sahin
Other Authors: Sloan School of Management
Format: Article
Published: Multidisciplinary Digital Publishing Institute 2025
Online Access:https://hdl.handle.net/1721.1/158299
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author Khaniyev, Taghi
Cekic, Efecan
Gecici, Neslihan Nisa
Can, Sinem
Ata, Naim
Ulgu, Mustafa Mahir
Birinci, Suayip
Isikay, Ahmet Ilkay
Bakir, Abdurrahman
Arat, Anil
Hanalioglu, Sahin
author2 Sloan School of Management
author_facet Sloan School of Management
Khaniyev, Taghi
Cekic, Efecan
Gecici, Neslihan Nisa
Can, Sinem
Ata, Naim
Ulgu, Mustafa Mahir
Birinci, Suayip
Isikay, Ahmet Ilkay
Bakir, Abdurrahman
Arat, Anil
Hanalioglu, Sahin
author_sort Khaniyev, Taghi
collection MIT
description Background/Objective: Subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality rates, necessitating prognostic algorithms to guide decisions. Our study evaluates the use of machine learning (ML) models for predicting 1-month and 1-year mortality among SAH patients using national electronic health records (EHR) system. Methods: Retrospective cohort of 29,274 SAH patients, identified through national EHR system from January 2017 to December 2022, was analyzed, with mortality data obtained from central civil registration system in Türkiye. Variables included (n = 102) pre- (n = 65) and post-admission (n = 37) data, such as patient demographics, clinical presentation, comorbidities, laboratory results, and complications. We employed logistic regression (LR), decision trees (DTs), random forests (RFs), and artificial neural networks (ANN). Model performance was evaluated using area under the curve (AUC), average precision, and accuracy. Feature significance analysis was conducted using LR. Results: The average age was 56.23 ± 16.45 years (47.8% female). The overall mortality rate was 22.8% at 1 month and 33.3% at 1 year. One-month mortality increased from 20.9% to 24.57% (p < 0.001), and 1-year mortality rose from 30.85% to 35.55% (p < 0.001) in the post-COVID period compared to the pre-COVID period. For 1-month mortality prediction, the ANN, LR, RF, and DT models achieved AUCs of 0.946, 0.942, 0.931, and 0.916, with accuracies of 0.905, 0.901, 0.893, and 0.885, respectively. For 1-year mortality, the AUCs were 0.941, 0.927, 0.926, and 0.907, with accuracies of 0.884, 0.875, 0.861, and 0.851, respectively. Key predictors of mortality included age, cardiopulmonary arrest, abnormal laboratory results (such as abnormal glucose and lactate levels) at presentation, and pre-existing comorbidities. Incorporating post-admission features (n = 37) alongside pre-admission features (n = 65) improved model performance for both 1-month and 1-year mortality predictions, with average AUC improvements of 0.093 ± 0.011 and 0.089 ± 0.012, respectively. Conclusions: Our study demonstrates the effectiveness of ML models in predicting mortality in SAH patients using big data. LR models’ robustness, interpretability, and feature significance analysis validate its importance. Including post-admission data significantly improved all models’ performances. Our results demonstrate the utility of big data analytics in population-level health outcomes studies.
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spelling mit-1721.1/1582992025-03-04T18:14:49Z Predicting Mortality in Subarachnoid Hemorrhage Patients Using Big Data and Machine Learning: A Nationwide Study in Türkiye Khaniyev, Taghi Cekic, Efecan Gecici, Neslihan Nisa Can, Sinem Ata, Naim Ulgu, Mustafa Mahir Birinci, Suayip Isikay, Ahmet Ilkay Bakir, Abdurrahman Arat, Anil Hanalioglu, Sahin Sloan School of Management Background/Objective: Subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality rates, necessitating prognostic algorithms to guide decisions. Our study evaluates the use of machine learning (ML) models for predicting 1-month and 1-year mortality among SAH patients using national electronic health records (EHR) system. Methods: Retrospective cohort of 29,274 SAH patients, identified through national EHR system from January 2017 to December 2022, was analyzed, with mortality data obtained from central civil registration system in Türkiye. Variables included (n = 102) pre- (n = 65) and post-admission (n = 37) data, such as patient demographics, clinical presentation, comorbidities, laboratory results, and complications. We employed logistic regression (LR), decision trees (DTs), random forests (RFs), and artificial neural networks (ANN). Model performance was evaluated using area under the curve (AUC), average precision, and accuracy. Feature significance analysis was conducted using LR. Results: The average age was 56.23 ± 16.45 years (47.8% female). The overall mortality rate was 22.8% at 1 month and 33.3% at 1 year. One-month mortality increased from 20.9% to 24.57% (p < 0.001), and 1-year mortality rose from 30.85% to 35.55% (p < 0.001) in the post-COVID period compared to the pre-COVID period. For 1-month mortality prediction, the ANN, LR, RF, and DT models achieved AUCs of 0.946, 0.942, 0.931, and 0.916, with accuracies of 0.905, 0.901, 0.893, and 0.885, respectively. For 1-year mortality, the AUCs were 0.941, 0.927, 0.926, and 0.907, with accuracies of 0.884, 0.875, 0.861, and 0.851, respectively. Key predictors of mortality included age, cardiopulmonary arrest, abnormal laboratory results (such as abnormal glucose and lactate levels) at presentation, and pre-existing comorbidities. Incorporating post-admission features (n = 37) alongside pre-admission features (n = 65) improved model performance for both 1-month and 1-year mortality predictions, with average AUC improvements of 0.093 ± 0.011 and 0.089 ± 0.012, respectively. Conclusions: Our study demonstrates the effectiveness of ML models in predicting mortality in SAH patients using big data. LR models’ robustness, interpretability, and feature significance analysis validate its importance. Including post-admission data significantly improved all models’ performances. Our results demonstrate the utility of big data analytics in population-level health outcomes studies. 2025-03-04T18:14:47Z 2025-03-04T18:14:47Z 2025-02-10 2025-02-25T13:05:00Z Article http://purl.org/eprint/type/JournalArticle https://hdl.handle.net/1721.1/158299 Khaniyev, T.; Cekic, E.; Gecici, N.N.; Can, S.; Ata, N.; Ulgu, M.M.; Birinci, S.; Isikay, A.I.; Bakir, A.; Arat, A.; et al. Predicting Mortality in Subarachnoid Hemorrhage Patients Using Big Data and Machine Learning: A Nationwide Study in Türkiye. J. Clin. Med. 2025, 14, 1144. PUBLISHER_CC http://dx.doi.org/10.3390/jcm14041144 Journal of Clinical Medicine Creative Commons Attribution https://creativecommons.org/licenses/by/4.0/ application/pdf Multidisciplinary Digital Publishing Institute Multidisciplinary Digital Publishing Institute
spellingShingle Khaniyev, Taghi
Cekic, Efecan
Gecici, Neslihan Nisa
Can, Sinem
Ata, Naim
Ulgu, Mustafa Mahir
Birinci, Suayip
Isikay, Ahmet Ilkay
Bakir, Abdurrahman
Arat, Anil
Hanalioglu, Sahin
Predicting Mortality in Subarachnoid Hemorrhage Patients Using Big Data and Machine Learning: A Nationwide Study in Türkiye
title Predicting Mortality in Subarachnoid Hemorrhage Patients Using Big Data and Machine Learning: A Nationwide Study in Türkiye
title_full Predicting Mortality in Subarachnoid Hemorrhage Patients Using Big Data and Machine Learning: A Nationwide Study in Türkiye
title_fullStr Predicting Mortality in Subarachnoid Hemorrhage Patients Using Big Data and Machine Learning: A Nationwide Study in Türkiye
title_full_unstemmed Predicting Mortality in Subarachnoid Hemorrhage Patients Using Big Data and Machine Learning: A Nationwide Study in Türkiye
title_short Predicting Mortality in Subarachnoid Hemorrhage Patients Using Big Data and Machine Learning: A Nationwide Study in Türkiye
title_sort predicting mortality in subarachnoid hemorrhage patients using big data and machine learning a nationwide study in turkiye
url https://hdl.handle.net/1721.1/158299
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