A machine learning approach to identify patients at risk for long-term consequences after pulmonary embolism

Pulmonary embolism (PE) can result in long-term sequelae, such as post-PE syndrome, including persistent dyspnea and chronic thromboembolic pulmonary hypertension (CTEPH). Existing prediction tools for severe post-PE complications lack sensitivity and specificity. This study aimed to develop a machi...

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Detalles Bibliográficos
Autores: Nopp, S, Spielvogel, C, Bikdeli, B, Alberich-Conesa, A, Hernández-Blasco, L, Peris, ML, Otero, R, Jimenez, D, Monreal, M, Ay, C, de Blas, PA, Aibar, J, Alda-Lozano, A, Alfonso, J, Alonso-Carrillo, J, Alvarez-Vega, P, Amado, C, Angelina-Garcia, M, Arcelus, JI, Ballaz, A, Barba, R, Barbagelata, C, Barrón, M, Barrón-Andres, B, Bascuñana, J, Blanco-Molina, A, Bustos-Carpio, J, Casado, I, Chasco, L, Claver, G, De Juana-Izquierdo, C, Del Toro, J, Demelo-Rodriguez, P, Diaz-Brasero, AM, Diaz-Pedroche, MC, Diaz-Peromingo, JA, Dubois-Silva, A, Escribano, JC, Fernández-Capitán, C, Fernández-Jimenez, B, Fernández-Reyes, JL, Fidalgo, MA, Francisco, I, Gabara, C, Galeano-Valle, F, Garcia-Bragado, F, Garcia-González, C, Garcia-Ortega, A, Gavin-Sebastián, O, de Gómez, MAG, Gil-Diaz, A, Gómez-Cepeda, C, Gómez-Cuervo, C, González-Martinez, J, González-Munera, A, Gorostidi, J, Grau, E, Guirado, L, Gutierrez-Guisado, J, Jara-Palomares, L, Jou, I, Joya, MD, Láinez-Justo, S, Lecumberri, R, Lobo, JL, López-Jimenez, L, López-Miguel, P, López-Núñez, JJ, López-Ruiz, A, López-Sáez, JB, Lorenzo, A, Madridano, O, Maestre, A, Marchena, PJ, Marcos, M, Pozo, MMD, Martin-Martos, F, Maza, JM, Mercado, MI, Molino, A, Monzón, L, Navas, MS, Nieto, JA, Núñez-Fernández, MJ, Ordieres, L, Ortiz, O, Otálora, S, Pacheco-Gómez, N, Pagán, J, Parra-Caballero, P, Pedrajas, JM, Perez-Amorós, J, Perez-Cabezas, A, Perez-Ductor, C, Perez-Pinar, M, Pesce, ML, Porras, JA, Puchades, R, Puche, G, Rivas, A, Rivera-Civico, F, Rodriguez-Cobo, A, Romero-Bruguera, M, Salgueiro, G, Sánchez-Juez, A, Sancho, T, Sendin, V, Sigüenza, P, Soler, S, Sota-Yoldi, LA, Suárez-Fernández, S, Tirado, R, Torrents-Vilar, A, Torres, MI, Trujillo-Santos, J, Uresandi, F, Valle, R, Varona, JF, Vázquez, E, Villalobos, A, Villarejo, C, Villares, P, Pabinger, I, Vanassche, T, Verhamme, P, Verstraete, A, Rocha, AT, Yoo, HHB, Montenegro, AC, Morales, SN, Roa, J, Hirmerova, J, Maly, R, Acassat, S, Bertoletti, L, Brehon, M, Bura-Riviere, A, Catella, J, Chopard, R, Couturaud, F, Espitia, O, Le Mao, R, Leclercq, B, Mahe, I, Moustafa, F, Plaisance, L, Poenou, G, Quere, I, Sarlon-Bartoli, G, Suchon, P, Versini, E, Schellong, S, Rashidi, F, Sadeghipour, P, Tahmasbi, F, Brenner, B, Kennet, G, Tzoran, I, Barillari, G, Basaglia, M, Bilora, F, Bissacco, D, Brandolin, B, Casana, R, Ciammaichella, MM, Colaizzo, D, Di Micco, P, Giorgi-Pierfranceschi, M, Grandone, E, Lambertenghi-Deliliers, D, Marcon, C, Poz, A, Prandoni, P, Simioni, P, Siniscalchi, C, Taflaj, B, Tufano, A, Visonà, A, Zalunardo, B, Skride, A, Tazi-Mezalek, Z, Fonseca, S, Marques, R, Meireles, J, Pinto, S, Bosevski, M, Zdraveska, M, Barco, S, Bounameaux, H, Keller, S, Mazzolai, L, Porceddu, E, Aujayeb, A, Angiolillo, DJ, Caprini, JA, Khalil, A, Ortega-Paz, L, Tafur, J, Weinberg, I, Bui, HM
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p11386
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones11386
https://doi.org/10.1038/s41598-025-14893-1
Access Level:acceso abierto
Palabra clave:Pulmonary embolism
Venous thromboembolism
Machine learning
Prediction
Dyspnea
Pulmonary arterial hypertension
id ES_e99c949aad6bedefea5eb8ce10cf99ee
oai_identifier_str oai:isabial.fundanetsuite.com:p11386
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv A machine learning approach to identify patients at risk for long-term consequences after pulmonary embolism
title A machine learning approach to identify patients at risk for long-term consequences after pulmonary embolism
spellingShingle A machine learning approach to identify patients at risk for long-term consequences after pulmonary embolism
Nopp, S
Pulmonary embolism
Venous thromboembolism
Machine learning
Prediction
Dyspnea
Pulmonary arterial hypertension
title_short A machine learning approach to identify patients at risk for long-term consequences after pulmonary embolism
title_full A machine learning approach to identify patients at risk for long-term consequences after pulmonary embolism
title_fullStr A machine learning approach to identify patients at risk for long-term consequences after pulmonary embolism
title_full_unstemmed A machine learning approach to identify patients at risk for long-term consequences after pulmonary embolism
title_sort A machine learning approach to identify patients at risk for long-term consequences after pulmonary embolism
dc.creator.none.fl_str_mv Nopp, S
Spielvogel, C
Bikdeli, B
Alberich-Conesa, A
Hernández-Blasco, L
Peris, ML
Otero, R
Jimenez, D
Monreal, M
Ay, C
de Blas, PA
Aibar, J
Alberich-Conesa, A
Alda-Lozano, A
Alfonso, J
Alonso-Carrillo, J
Alvarez-Vega, P
Amado, C
Angelina-Garcia, M
Arcelus, JI
Ballaz, A
Barba, R
Barbagelata, C
Barrón, M
Barrón-Andres, B
Bascuñana, J
Blanco-Molina, A
Bustos-Carpio, J
Casado, I
Chasco, L
Claver, G
De Juana-Izquierdo, C
Del Toro, J
Demelo-Rodriguez, P
Diaz-Brasero, AM
Diaz-Pedroche, MC
Diaz-Peromingo, JA
Dubois-Silva, A
Escribano, JC
Fernández-Capitán, C
Fernández-Jimenez, B
Fernández-Reyes, JL
Fidalgo, MA
Francisco, I
Gabara, C
Galeano-Valle, F
Garcia-Bragado, F
Garcia-González, C
Garcia-Ortega, A
Gavin-Sebastián, O
de Gómez, MAG
Gil-Diaz, A
Gómez-Cepeda, C
Gómez-Cuervo, C
González-Martinez, J
González-Munera, A
Gorostidi, J
Grau, E
Guirado, L
Gutierrez-Guisado, J
Hernández-Blasco, L
Jara-Palomares, L
Jimenez, D
Jou, I
Joya, MD
Láinez-Justo, S
Lecumberri, R
Lobo, JL
López-Jimenez, L
López-Miguel, P
López-Núñez, JJ
López-Ruiz, A
López-Sáez, JB
Lorenzo, A
Madridano, O
Maestre, A
Marchena, PJ
Marcos, M
Pozo, MMD
Martin-Martos, F
Maza, JM
Mercado, MI
Molino, A
Monreal, M
Monzón, L
Navas, MS
Nieto, JA
Núñez-Fernández, MJ
Ordieres, L
Ortiz, O
Otálora, S
Otero, R
Pacheco-Gómez, N
Pagán, J
Parra-Caballero, P
Pedrajas, JM
Perez-Amorós, J
Perez-Cabezas, A
Perez-Ductor, C
Perez-Pinar, M
Peris, ML
Pesce, ML
Porras, JA
Puchades, R
Puche, G
Rivas, A
Rivera-Civico, F
Rodriguez-Cobo, A
Romero-Bruguera, M
Salgueiro, G
Sánchez-Juez, A
Sancho, T
Sendin, V
Sigüenza, P
Soler, S
Sota-Yoldi, LA
Suárez-Fernández, S
Tirado, R
Torrents-Vilar, A
Torres, MI
Trujillo-Santos, J
Uresandi, F
Valle, R
Varona, JF
Vázquez, E
Villalobos, A
Villarejo, C
Villares, P
Ay, C
Nopp, S
Pabinger, I
Vanassche, T
Verhamme, P
Verstraete, A
Rocha, AT
Yoo, HHB
Montenegro, AC
Morales, SN
Roa, J
Hirmerova, J
Maly, R
Acassat, S
Bertoletti, L
Brehon, M
Bura-Riviere, A
Catella, J
Chopard, R
Couturaud, F
Espitia, O
Le Mao, R
Leclercq, B
Mahe, I
Moustafa, F
Plaisance, L
Poenou, G
Quere, I
Sarlon-Bartoli, G
Suchon, P
Versini, E
Schellong, S
Rashidi, F
Sadeghipour, P
Tahmasbi, F
Brenner, B
Kennet, G
Tzoran, I
Barillari, G
Basaglia, M
Bilora, F
Bissacco, D
Brandolin, B
Casana, R
Ciammaichella, MM
Colaizzo, D
Di Micco, P
Giorgi-Pierfranceschi, M
Grandone, E
Lambertenghi-Deliliers, D
Marcon, C
Poz, A
Prandoni, P
Simioni, P
Siniscalchi, C
Taflaj, B
Tufano, A
Visonà, A
Zalunardo, B
Skride, A
Tazi-Mezalek, Z
Fonseca, S
Marques, R
Meireles, J
Pinto, S
Bosevski, M
Zdraveska, M
Barco, S
Bounameaux, H
Keller, S
Mazzolai, L
Porceddu, E
Aujayeb, A
Angiolillo, DJ
Bikdeli, B
Caprini, JA
Khalil, A
Ortega-Paz, L
Tafur, J
Weinberg, I
Bui, HM
author Nopp, S
author_facet Nopp, S
Spielvogel, C
Bikdeli, B
Alberich-Conesa, A
Hernández-Blasco, L
Peris, ML
Otero, R
Jimenez, D
Monreal, M
Ay, C
de Blas, PA
Aibar, J
Alda-Lozano, A
Alfonso, J
Alonso-Carrillo, J
Alvarez-Vega, P
Amado, C
Angelina-Garcia, M
Arcelus, JI
Ballaz, A
Barba, R
Barbagelata, C
Barrón, M
Barrón-Andres, B
Bascuñana, J
Blanco-Molina, A
Bustos-Carpio, J
Casado, I
Chasco, L
Claver, G
De Juana-Izquierdo, C
Del Toro, J
Demelo-Rodriguez, P
Diaz-Brasero, AM
Diaz-Pedroche, MC
Diaz-Peromingo, JA
Dubois-Silva, A
Escribano, JC
Fernández-Capitán, C
Fernández-Jimenez, B
Fernández-Reyes, JL
Fidalgo, MA
Francisco, I
Gabara, C
Galeano-Valle, F
Garcia-Bragado, F
Garcia-González, C
Garcia-Ortega, A
Gavin-Sebastián, O
de Gómez, MAG
Gil-Diaz, A
Gómez-Cepeda, C
Gómez-Cuervo, C
González-Martinez, J
González-Munera, A
Gorostidi, J
Grau, E
Guirado, L
Gutierrez-Guisado, J
Jara-Palomares, L
Jou, I
Joya, MD
Láinez-Justo, S
Lecumberri, R
Lobo, JL
López-Jimenez, L
López-Miguel, P
López-Núñez, JJ
López-Ruiz, A
López-Sáez, JB
Lorenzo, A
Madridano, O
Maestre, A
Marchena, PJ
Marcos, M
Pozo, MMD
Martin-Martos, F
Maza, JM
Mercado, MI
Molino, A
Monzón, L
Navas, MS
Nieto, JA
Núñez-Fernández, MJ
Ordieres, L
Ortiz, O
Otálora, S
Pacheco-Gómez, N
Pagán, J
Parra-Caballero, P
Pedrajas, JM
Perez-Amorós, J
Perez-Cabezas, A
Perez-Ductor, C
Perez-Pinar, M
Pesce, ML
Porras, JA
Puchades, R
Puche, G
Rivas, A
Rivera-Civico, F
Rodriguez-Cobo, A
Romero-Bruguera, M
Salgueiro, G
Sánchez-Juez, A
Sancho, T
Sendin, V
Sigüenza, P
Soler, S
Sota-Yoldi, LA
Suárez-Fernández, S
Tirado, R
Torrents-Vilar, A
Torres, MI
Trujillo-Santos, J
Uresandi, F
Valle, R
Varona, JF
Vázquez, E
Villalobos, A
Villarejo, C
Villares, P
Pabinger, I
Vanassche, T
Verhamme, P
Verstraete, A
Rocha, AT
Yoo, HHB
Montenegro, AC
Morales, SN
Roa, J
Hirmerova, J
Maly, R
Acassat, S
Bertoletti, L
Brehon, M
Bura-Riviere, A
Catella, J
Chopard, R
Couturaud, F
Espitia, O
Le Mao, R
Leclercq, B
Mahe, I
Moustafa, F
Plaisance, L
Poenou, G
Quere, I
Sarlon-Bartoli, G
Suchon, P
Versini, E
Schellong, S
Rashidi, F
Sadeghipour, P
Tahmasbi, F
Brenner, B
Kennet, G
Tzoran, I
Barillari, G
Basaglia, M
Bilora, F
Bissacco, D
Brandolin, B
Casana, R
Ciammaichella, MM
Colaizzo, D
Di Micco, P
Giorgi-Pierfranceschi, M
Grandone, E
Lambertenghi-Deliliers, D
Marcon, C
Poz, A
Prandoni, P
Simioni, P
Siniscalchi, C
Taflaj, B
Tufano, A
Visonà, A
Zalunardo, B
Skride, A
Tazi-Mezalek, Z
Fonseca, S
Marques, R
Meireles, J
Pinto, S
Bosevski, M
Zdraveska, M
Barco, S
Bounameaux, H
Keller, S
Mazzolai, L
Porceddu, E
Aujayeb, A
Angiolillo, DJ
Caprini, JA
Khalil, A
Ortega-Paz, L
Tafur, J
Weinberg, I
Bui, HM
author_role author
author2 Spielvogel, C
Bikdeli, B
Alberich-Conesa, A
Hernández-Blasco, L
Peris, ML
Otero, R
Jimenez, D
Monreal, M
Ay, C
de Blas, PA
Aibar, J
Alda-Lozano, A
Alfonso, J
Alonso-Carrillo, J
Alvarez-Vega, P
Amado, C
Angelina-Garcia, M
Arcelus, JI
Ballaz, A
Barba, R
Barbagelata, C
Barrón, M
Barrón-Andres, B
Bascuñana, J
Blanco-Molina, A
Bustos-Carpio, J
Casado, I
Chasco, L
Claver, G
De Juana-Izquierdo, C
Del Toro, J
Demelo-Rodriguez, P
Diaz-Brasero, AM
Diaz-Pedroche, MC
Diaz-Peromingo, JA
Dubois-Silva, A
Escribano, JC
Fernández-Capitán, C
Fernández-Jimenez, B
Fernández-Reyes, JL
Fidalgo, MA
Francisco, I
Gabara, C
Galeano-Valle, F
Garcia-Bragado, F
Garcia-González, C
Garcia-Ortega, A
Gavin-Sebastián, O
de Gómez, MAG
Gil-Diaz, A
Gómez-Cepeda, C
Gómez-Cuervo, C
González-Martinez, J
González-Munera, A
Gorostidi, J
Grau, E
Guirado, L
Gutierrez-Guisado, J
Jara-Palomares, L
Jou, I
Joya, MD
Láinez-Justo, S
Lecumberri, R
Lobo, JL
López-Jimenez, L
López-Miguel, P
López-Núñez, JJ
López-Ruiz, A
López-Sáez, JB
Lorenzo, A
Madridano, O
Maestre, A
Marchena, PJ
Marcos, M
Pozo, MMD
Martin-Martos, F
Maza, JM
Mercado, MI
Molino, A
Monzón, L
Navas, MS
Nieto, JA
Núñez-Fernández, MJ
Ordieres, L
Ortiz, O
Otálora, S
Pacheco-Gómez, N
Pagán, J
Parra-Caballero, P
Pedrajas, JM
Perez-Amorós, J
Perez-Cabezas, A
Perez-Ductor, C
Perez-Pinar, M
Pesce, ML
Porras, JA
Puchades, R
Puche, G
Rivas, A
Rivera-Civico, F
Rodriguez-Cobo, A
Romero-Bruguera, M
Salgueiro, G
Sánchez-Juez, A
Sancho, T
Sendin, V
Sigüenza, P
Soler, S
Sota-Yoldi, LA
Suárez-Fernández, S
Tirado, R
Torrents-Vilar, A
Torres, MI
Trujillo-Santos, J
Uresandi, F
Valle, R
Varona, JF
Vázquez, E
Villalobos, A
Villarejo, C
Villares, P
Pabinger, I
Vanassche, T
Verhamme, P
Verstraete, A
Rocha, AT
Yoo, HHB
Montenegro, AC
Morales, SN
Roa, J
Hirmerova, J
Maly, R
Acassat, S
Bertoletti, L
Brehon, M
Bura-Riviere, A
Catella, J
Chopard, R
Couturaud, F
Espitia, O
Le Mao, R
Leclercq, B
Mahe, I
Moustafa, F
Plaisance, L
Poenou, G
Quere, I
Sarlon-Bartoli, G
Suchon, P
Versini, E
Schellong, S
Rashidi, F
Sadeghipour, P
Tahmasbi, F
Brenner, B
Kennet, G
Tzoran, I
Barillari, G
Basaglia, M
Bilora, F
Bissacco, D
Brandolin, B
Casana, R
Ciammaichella, MM
Colaizzo, D
Di Micco, P
Giorgi-Pierfranceschi, M
Grandone, E
Lambertenghi-Deliliers, D
Marcon, C
Poz, A
Prandoni, P
Simioni, P
Siniscalchi, C
Taflaj, B
Tufano, A
Visonà, A
Zalunardo, B
Skride, A
Tazi-Mezalek, Z
Fonseca, S
Marques, R
Meireles, J
Pinto, S
Bosevski, M
Zdraveska, M
Barco, S
Bounameaux, H
Keller, S
Mazzolai, L
Porceddu, E
Aujayeb, A
Angiolillo, DJ
Caprini, JA
Khalil, A
Ortega-Paz, L
Tafur, J
Weinberg, I
Bui, HM
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dc.subject.none.fl_str_mv Pulmonary embolism
Venous thromboembolism
Machine learning
Prediction
Dyspnea
Pulmonary arterial hypertension
topic Pulmonary embolism
Venous thromboembolism
Machine learning
Prediction
Dyspnea
Pulmonary arterial hypertension
description Pulmonary embolism (PE) can result in long-term sequelae, such as post-PE syndrome, including persistent dyspnea and chronic thromboembolic pulmonary hypertension (CTEPH). Existing prediction tools for severe post-PE complications lack sensitivity and specificity. This study aimed to develop a machine learning model to identify patients at risk for long-term consequences after PE. Using data from the RIETE registry, the largest prospective international PE registry, we developed supervised machine learning models to identify patients at increased risk of CTEPH and post-PE syndrome. Our approach involved data preprocessing, model training via random forest algorithm, and validation through Monte-Carlo cross-validation. The performance of the CTEPH prediction model was benchmarked against an existing score. Of the 57,981 PE patients in the RIETE registry, 5,217 were eligible for inclusion. Median age was 68 years, with 50.6% men. Machine learning was based on 111 predictor variables, with 171 patients (3.3%) developing CTEPH. The CTEPH model demonstrated good performance with an AUC of 0.74 (95%CI: 0.73-0.75), significantly outperforming the existing CTEPH prediction score (0.57; 0.54-0.61). Additionally, 1,310 (25.1%) patients were defined as having post-PE syndrome six months after index PE. The post-PE syndrome model showed poorer performance with an AUC of 0.62 (0.61-0.62). Key predictor variables across both models included chest pain at presentation, PE location, troponin, side of clot, and dyspnea at presentation. Machine learning models show promise in predicting CTEPH but are less effective for post-PE syndrome. Future refinement, including integrating imaging data, is necessary to improve predictive performance and clinical utility.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://isabial.portalinvestigacion.com/publicaciones11386
https://doi.org/10.1038/s41598-025-14893-1
url https://isabial.portalinvestigacion.com/publicaciones11386
https://doi.org/10.1038/s41598-025-14893-1
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv NATURE PORTFOLIO
publisher.none.fl_str_mv NATURE PORTFOLIO
dc.source.none.fl_str_mv Scientific Reports
ISSN: 20452322
reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling A machine learning approach to identify patients at risk for long-term consequences after pulmonary embolismNopp, SSpielvogel, CBikdeli, BAlberich-Conesa, AHernández-Blasco, LPeris, MLOtero, RJimenez, DMonreal, MAy, Cde Blas, PAAibar, JAlberich-Conesa, AAlda-Lozano, AAlfonso, JAlonso-Carrillo, JAlvarez-Vega, PAmado, CAngelina-Garcia, MArcelus, JIBallaz, ABarba, RBarbagelata, CBarrón, MBarrón-Andres, BBascuñana, JBlanco-Molina, ABustos-Carpio, JCasado, IChasco, LClaver, GDe Juana-Izquierdo, CDel Toro, JDemelo-Rodriguez, PDiaz-Brasero, AMDiaz-Pedroche, MCDiaz-Peromingo, JADubois-Silva, AEscribano, JCFernández-Capitán, CFernández-Jimenez, BFernández-Reyes, JLFidalgo, MAFrancisco, IGabara, CGaleano-Valle, FGarcia-Bragado, FGarcia-González, CGarcia-Ortega, AGavin-Sebastián, Ode Gómez, MAGGil-Diaz, AGómez-Cepeda, CGómez-Cuervo, CGonzález-Martinez, JGonzález-Munera, AGorostidi, JGrau, EGuirado, LGutierrez-Guisado, JHernández-Blasco, LJara-Palomares, LJimenez, DJou, IJoya, MDLáinez-Justo, SLecumberri, RLobo, JLLópez-Jimenez, LLópez-Miguel, PLópez-Núñez, JJLópez-Ruiz, ALópez-Sáez, JBLorenzo, AMadridano, OMaestre, AMarchena, PJMarcos, MPozo, MMDMartin-Martos, FMaza, JMMercado, MIMolino, AMonreal, MMonzón, LNavas, MSNieto, JANúñez-Fernández, MJOrdieres, LOrtiz, OOtálora, SOtero, RPacheco-Gómez, NPagán, JParra-Caballero, PPedrajas, JMPerez-Amorós, JPerez-Cabezas, APerez-Ductor, CPerez-Pinar, MPeris, MLPesce, MLPorras, JAPuchades, RPuche, GRivas, ARivera-Civico, FRodriguez-Cobo, ARomero-Bruguera, MSalgueiro, GSánchez-Juez, ASancho, TSendin, VSigüenza, PSoler, SSota-Yoldi, LASuárez-Fernández, STirado, RTorrents-Vilar, ATorres, MITrujillo-Santos, JUresandi, FValle, RVarona, JFVázquez, EVillalobos, AVillarejo, CVillares, PAy, CNopp, SPabinger, IVanassche, TVerhamme, PVerstraete, ARocha, ATYoo, HHBMontenegro, ACMorales, SNRoa, JHirmerova, JMaly, RAcassat, SBertoletti, LBrehon, MBura-Riviere, ACatella, JChopard, RCouturaud, FEspitia, OLe Mao, RLeclercq, BMahe, IMoustafa, FPlaisance, LPoenou, GQuere, ISarlon-Bartoli, GSuchon, PVersini, ESchellong, SRashidi, FSadeghipour, PTahmasbi, FBrenner, BKennet, GTzoran, IBarillari, GBasaglia, MBilora, FBissacco, DBrandolin, BCasana, RCiammaichella, MMColaizzo, DDi Micco, PGiorgi-Pierfranceschi, MGrandone, ELambertenghi-Deliliers, DMarcon, CPoz, APrandoni, PSimioni, PSiniscalchi, CTaflaj, BTufano, AVisonà, AZalunardo, BSkride, ATazi-Mezalek, ZFonseca, SMarques, RMeireles, JPinto, SBosevski, MZdraveska, MBarco, SBounameaux, HKeller, SMazzolai, LPorceddu, EAujayeb, AAngiolillo, DJBikdeli, BCaprini, JAKhalil, AOrtega-Paz, LTafur, JWeinberg, IBui, HMPulmonary embolismVenous thromboembolismMachine learningPredictionDyspneaPulmonary arterial hypertensionPulmonary embolism (PE) can result in long-term sequelae, such as post-PE syndrome, including persistent dyspnea and chronic thromboembolic pulmonary hypertension (CTEPH). Existing prediction tools for severe post-PE complications lack sensitivity and specificity. This study aimed to develop a machine learning model to identify patients at risk for long-term consequences after PE. Using data from the RIETE registry, the largest prospective international PE registry, we developed supervised machine learning models to identify patients at increased risk of CTEPH and post-PE syndrome. Our approach involved data preprocessing, model training via random forest algorithm, and validation through Monte-Carlo cross-validation. The performance of the CTEPH prediction model was benchmarked against an existing score. Of the 57,981 PE patients in the RIETE registry, 5,217 were eligible for inclusion. Median age was 68 years, with 50.6% men. Machine learning was based on 111 predictor variables, with 171 patients (3.3%) developing CTEPH. The CTEPH model demonstrated good performance with an AUC of 0.74 (95%CI: 0.73-0.75), significantly outperforming the existing CTEPH prediction score (0.57; 0.54-0.61). Additionally, 1,310 (25.1%) patients were defined as having post-PE syndrome six months after index PE. The post-PE syndrome model showed poorer performance with an AUC of 0.62 (0.61-0.62). Key predictor variables across both models included chest pain at presentation, PE location, troponin, side of clot, and dyspnea at presentation. Machine learning models show promise in predicting CTEPH but are less effective for post-PE syndrome. Future refinement, including integrating imaging data, is necessary to improve predictive performance and clinical utility.NATURE PORTFOLIO2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones11386https://doi.org/10.1038/s41598-025-14893-1Scientific ReportsISSN: 20452322reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p113862026-06-12T10:20:37Z
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