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研究生： 安曼方
Bayu Fandhi, Achmad
論文名稱： 使用機器學習法預測急性心肌梗塞病人經皮冠狀動脈介入治療後的住院死亡率
Predictive Model of In-Hospital Mortality in Patients with Acute Myocardial Infarction Following Percutaneous Coronary Intervention Using A Machine Learning Approach
指導教授： 陳幸眉
Chen, Hsing-Mei
學位類別： 博士
Doctor
系所名稱： 醫學院 - 護理學系
Department of Nursing
論文出版年： 2025
畢業學年度： 113
語文別： 英文
論文頁數： 143
中文關鍵詞： 急性心肌梗塞 、經皮冠狀動脈介入治療 、院內死亡率 、機器學習 、預測模型
外文關鍵詞： Acute myocardial infarction, percutaneous coronary intervention, in-hospital mortality, machine learning, prediction model
相關次數： 點閱：26  下載：0 
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    • CERTIFICATE OF APPROVAL FOR DOCTORAL DISSERTATION i 摘要 ii ABSTRACT iv ACKNOWLEDGEMENTS vi TABLE OF CONTENTS vii LIST OF TABLES xi LIST OF FIGURES xii CHAPTER I 1 INTRODUCTION 1 1.1 Background 1 1.2 Significance of the study 2 1.3 Research purposes 4 1.4 Research questions 5 1.5 Conceptual framework 5 1.6 Definition of the terms 8 1.6.1 In-hospital mortality in patients following PCI 8 1.6.2 Acute myocardial infarction 8 1.6.3 Percutaneous coronary intervention 9 1.6.4 Machine Learning 9 CHAPTER II 10 LITERATURE REVIEW 10 2.1 Overview of acute myocardial infarction 10 2.2 Definition of acute myocardial infarction 11 2.3 Mechanism of myocardial injury 13 2.4 Coronary collateral circulation in patients with acute myocardial infarction 15 2.5 Oncosis, apoptosis, and autophagic myocyte death 16 2.6 Clinical manifestations of myocardial infarction 17 2.7 Recent evidence of percutaneous coronary Intervention 19 2.8 In-hospital mortality in patients with AMI following PCI 23 2.9 Factors associated with in-hospital mortality in patients following PCI 25 2.10 In-hospital mortality risk factors in Indonesia 28 2.11 Studies related to in-hospital mortality used machine learning 29 2.12 Summary of Chapter II 31 CHAPTER III 32 METHODS 32 3.1 Study design and setting 32 3.2 Samples 32 3.3 Study instruments 34 3.4 Data collection procedures 38 3.5 Data analysis 39 3.6 Ethical consideration 45 3.7 Summary of Chapter III 46 CHAPTER IV 47 RESULTS 47 4.1 Research question 1: What were the prevalences of in-hospital mortality among patients with AMI following PCI in Indonesia from 2019 to 2023 and its demographic characteristics? 47 4.1.1 Number of PCI procedures and in-hospital mortality rate 47 4.1.2 Demographic characteristics of participants 48 4.1.3 Cardiac functions domain 49 4.1.4 Hemodynamics domain 51 4.1.5 Laboratory data domain 51 4.1.6 Comorbidity domain 52 4.1.7 Periprocedural therapy domain 53 4.2 Research question 2: What were the differences in the prevalences of in-hospital mortality over the five-year period and the comparison of demographic characteristics by survival status? 54 4.2.1 Differences in the prevalences of in-hospital mortality over five-year 54 4.2.2 Comparisons of demographic characteristics by survival status 55 4.2.3 Comparisons of cardiac function by survival status 56 4.2.4 Comparisons of hemodynamics by survival status 58 4.2.5 Comparisons of laboratory data by survival status 59 4.2.6 Comparisons of comorbidity by survival status 61 4.2.7 Comparisons of periprocedural characteristics by survival status 62 4.3 Research Question 3: What were the important factors of in-hospital mortality among patients with AMI following PCI from 2019 to 2023? 62 4.3.1 Important factors of in-hospital mortality (all years) 64 4.3.2 Important factors of In-hospital mortality in AMI patients in 2019 66 4.3.3 Important factors of In-hospital mortality in AMI patients in 2020 70 4.3.4 Important factors of In-hospital mortality in AMI patients in 2021 73 4.3.5 Important factors of In-hospital mortality AMI patients in 2022. 76 4.3.6 Important factors of In-hospital mortality in AMI patients in 2023 79 4.4 Research question 4: What was the validity of the predictive model of in-hospital mortality among patients with AMI following PCI? 82 4.4.1 Predictive model of in-hospital mortality in AMI patients following PCI 82 4.4.2 Performance evaluation of the predictive model 83 4.4.3 Calibration of the predictive model 87 4.5 Summary of Chapter IV 89 CHAPTER V 90 DISCUSSION 90 5.1 Overall findings 90 5.2 In-hospital mortality rates in patients with AMI PCI and its demographics 90 5.3 Predictors of in-hospital mortality in patients with AMI following PCI 93 5.4 Predictive model of in-hospital mortality in AMI patients following PCI 97 5.5 Study limitations 99 CHAPTER VI 100 CONCLUSIONS AND IMPLICATIONS 100 6.1 Conclusions 100 6.2 Implications 100 6.2.1 Clinical practice 100 6.2.2 Nursing education 101 6.2.3 Nursing research 101 REFERENCES 103 Appendix 1: Instrument of the study 126 Appendix 2: IRB letter of this study 129 Appendix 3: Permission letter from the study hospital 130

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