Intelligent Data Engineering and Artificial Intelligence (IDEAI) Research Center, Computer Science, Universitat Politècnica de Catalunya, Barcelona, Spain.
Eurecat, Centre Tecnològic de Catalunya, eHealth, Data Analytics in Omics, Barcelona, Spain.
PLoS One. 2018 Nov 20;13(11):e0199089. doi: 10.1371/journal.pone.0199089. eCollection 2018.
Circulatory shock is a life-threatening disease that accounts for around one-third of all admissions to intensive care units (ICU). It requires immediate treatment, which is why the development of tools for planning therapeutic interventions is required to deal with shock in the critical care environment. In this study, the ShockOmics European project original database is used to extract attributes capable of predicting mortality due to shock in the ICU. Missing data imputation techniques and machine learning models were used, followed by feature selection from different data subsets. Selected features were later used to build Bayesian Networks, revealing causal relationships between features and ICU outcome. The main result is a subset of predictive features that includes well-known indicators such as the SOFA and APACHE II scores, but also less commonly considered ones related to cardiovascular function assessed through echocardiograpy or shock treatment with pressors. Importantly, certain selected features are shown to be most predictive at certain time-steps. This means that, as shock progresses, different attributes could be prioritized. Clinical traits obtained at 24h. from ICU admission are shown to accurately predict cardiogenic and septic shock mortality, suggesting that relevant life-saving decisions could be made shortly after ICU admission.
循环休克是一种危及生命的疾病,约占重症监护病房(ICU)所有入院人数的三分之一。它需要立即治疗,因此需要开发用于规划治疗干预的工具,以应对重症监护环境中的休克。在这项研究中,ShockOmics 欧洲项目原始数据库用于提取能够预测 ICU 休克死亡率的属性。使用了缺失数据插补技术和机器学习模型,然后从不同的子集中选择特征。选择的特征后来用于构建贝叶斯网络,揭示特征与 ICU 结果之间的因果关系。主要结果是一个预测特征子集,其中包括众所周知的指标,如 SOFA 和 APACHE II 评分,但也包括通过超声心动图评估心血管功能或使用升压药治疗休克时较少考虑的指标。重要的是,某些选定的特征在某些时间点显示出最具预测性。这意味着,随着休克的进展,可能会优先考虑不同的属性。在 ICU 入院后 24 小时获得的临床特征被证明可以准确预测心源性和脓毒性休克的死亡率,这表明在 ICU 入院后不久就可以做出相关的救生决策。