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Computational and Mathematical Methods in Medicine
Volume 2015, Article ID 303250, 10 pages
Research Article

Risk Prediction of One-Year Mortality in Patients with Cardiac Arrhythmias Using Random Survival Forest

1Key Laboratory for Health Informatics of the Chinese Academy of Sciences (HICAS), Shenzhen Institutes of Advanced Technology, Shenzhen 518055, China
2Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Beijing 100049, China
3Department of Senile Cardiovascular Medicine, The General Hospital of the People’s Liberation Army, Beijing 100853, China
4Joint Research Centre for Biomedical Engineering, Department of Electronic Engineering, Chinese University of Hong Kong, Shatin 00852, Hong Kong

Received 18 March 2015; Revised 26 June 2015; Accepted 28 July 2015

Academic Editor: Zoran Bursac

Copyright © 2015 Fen Miao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Existing models for predicting mortality based on traditional Cox proportional hazard approach (CPH) often have low prediction accuracy. This paper aims to develop a clinical risk model with good accuracy for predicting 1-year mortality in cardiac arrhythmias patients using random survival forest (RSF), a robust approach for survival analysis. 10,488 cardiac arrhythmias patients available in the public MIMIC II clinical database were investigated, with 3,452 deaths occurring within 1-year followups. Forty risk factors including demographics and clinical and laboratory information and antiarrhythmic agents were analyzed as potential predictors of all-cause mortality. RSF was adopted to build a comprehensive survival model and a simplified risk model composed of 14 top risk factors. The built comprehensive model achieved a prediction accuracy of 0.81 measured by c-statistic with 10-fold cross validation. The simplified risk model also achieved a good accuracy of 0.799. Both results outperformed traditional CPH (which achieved a c-statistic of 0.733 for the comprehensive model and 0.718 for the simplified model). Moreover, various factors are observed to have nonlinear impact on cardiac arrhythmias prognosis. As a result, RSF based model which took nonlinearity into account significantly outperformed traditional Cox proportional hazard model and has great potential to be a more effective approach for survival analysis.