Publication:
Patient-specific multifactorial mortality risk assessment using classification and regression tree analysis in the context of ambulatory blood pressure monitoring

dc.contributor.coauthorSiriopol,Ianis
dc.contributor.coauthorSiriopol,Dimitrie
dc.contributor.coauthorCiceri,Paola
dc.contributor.coauthorCozzolino,Mario
dc.contributor.departmentSchool of Medicine
dc.contributor.departmentGraduate School of Health Sciences
dc.contributor.kuauthorAkyol, Merve
dc.contributor.kuauthorÇetin, Bahar Tekin
dc.contributor.kuauthorÇevik, Enes
dc.contributor.kuauthorÇöpür, Sidar
dc.contributor.kuauthorErden, Mert Emre
dc.contributor.kuauthorGüldan, Mustafa
dc.contributor.kuauthorHasbal, Nuri Barış
dc.contributor.kuauthorKalay, Zeynepgül
dc.contributor.kuauthorKanbay, Mehmet
dc.contributor.kuauthorÖzbek, Laşin
dc.contributor.kuauthorŞahin, Özgün Ekin
dc.contributor.kuauthorTanrıöver, Cem
dc.contributor.kuauthorUçku, Duygu
dc.contributor.schoolcollegeinstituteGRADUATE SCHOOL OF HEALTH SCIENCES
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2025-03-06T20:59:10Z
dc.date.issued2024
dc.description.abstractBackground Ambulatory blood pressure monitoring is essential for understanding blood pressure patterns beyond clinical visits, aiding in risk assessment, treatment evaluation, and managing hypertension. This retrospective cohort study aimed to identify risk factors for all-cause mortality and major cardiovascular events in patients who underwent ambulatory blood pressure monitoring. Methodology Eligible participants aged 18 or older, with an estimated glomerular filtration rate (eGFR) > 60 ml/min/1.73 m(2), who underwent ambulatory blood pressure monitoring for various reasons, were included in the study. Data were gathered through telephone interviews, electronic health records, and the national health record system. Descriptive analysis and classification and regression tree modeling were used to uncover significant risk factors related to all-cause mortality and cardiovascular events, and to assess the model's performance compared to traditional Cox survival analysis. Results The study included 1291 patients, primarily male (51.8%) with a mean age of 61.1 +/- 15.2 years. During a mean follow-up of 46.9 months, 76 (5.9%) patients died of any cause, and 195 (15.1%) had a cardiovascular event. The highest survival rates were observed in patients with a diastolic blood pressure (BP) dipping percentage between - 2% and 29%, nighttime systolic BP variability below 32 mmHg, and age below 72. Conversely, smokers with a diastolic BP dipping percentage below - 10% showed the lowest survival rates. The best cardiovascular outcomes were observed in patients with diastolic BP dipping above - 11%, nighttime mean systolic BP < 144 mmHg, no statin use, normotensive status, and daytime mean heart rate >= 60 bpm. Conversely, the worst outcomes were seen in patients with diastolic BP dipping below - 11% and a morning surge >= 14 mmHg. In all-cause mortality and cardiovascular event analysis, the combined model demonstrated excellent calibration and predictive power, like the classification and regression tree model and traditional analysis. Conclusion These findings highlight the potential of a combined model for assessing mortality and cardiovascular event risk in patients who have undergone ambulatory blood pressure monitoring.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.identifier.doi10.1007/s40620-024-02128-x
dc.identifier.eissn1724-6059
dc.identifier.issn1121-8428
dc.identifier.quartileQ2
dc.identifier.scopus2-s2.0-85208735686
dc.identifier.urihttps://doi.org/10.1007/s40620-024-02128-x
dc.identifier.urihttps://hdl.handle.net/20.500.14288/27649
dc.identifier.wos1349424500002
dc.keywordsAmbulatory blood pressure monitoring
dc.keywordsCART analysis
dc.keywordsAll-cause mortality
dc.keywordsHypertension
dc.language.isoeng
dc.publisherSpringer Heidelberg
dc.relation.ispartofJournal of Nephrology
dc.subjectUrology and nephrology
dc.titlePatient-specific multifactorial mortality risk assessment using classification and regression tree analysis in the context of ambulatory blood pressure monitoring
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorÇetin, Bahar Tekin
local.contributor.kuauthorHasbal, Nuri Barış
local.contributor.kuauthorÇevik, Enes
local.contributor.kuauthorŞahin, Özgün Ekin
local.contributor.kuauthorAkyol, Merve
local.contributor.kuauthorKalay, Zeynepgül
local.contributor.kuauthorUçku, Duygu
local.contributor.kuauthorTanrıöver, Cem
local.contributor.kuauthorGüldan, Mustafa
local.contributor.kuauthorÖzbek, Laşin
local.contributor.kuauthorErden, Mert Emre
local.contributor.kuauthorÇöpür, Sidar
local.contributor.kuauthorKanbay, Mehmet
local.contributor.kuauthorMemetoğlu, Ponur
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit1GRADUATE SCHOOL OF HEALTH SCIENCES
local.publication.orgunit2School of Medicine
local.publication.orgunit2Graduate School of Health Sciences
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