Hyun Sookyung, Kaewprag Pacharmon, Cooper Cheryl, Hixon Brenda, Moffatt-Bruce Susan
College of Nursing, Pusan National University, 49 Busandaehak-ro Mulgeum-eup, Yangsan-si, 50612, South Korea.
Department of Computer Engineering, Ramkhamhaeng University, Bangkok, Thailand.
Comput Methods Programs Biomed. 2020 Oct;194:105507. doi: 10.1016/j.cmpb.2020.105507. Epub 2020 Apr 28.
Identification of subgroups may be useful to understand the clinical characteristics of ICU patients. The purposes of this study were to apply an unsupervised machine learning method to ICU patient data to discover subgroups among them; and to examine their clinical characteristics, therapeutic procedures conducted during the ICU stay, and discharge dispositions.
K-means clustering method was used with 1503 observations and 9 types of laboratory test results as features.
Three clusters were identified from this specific population. Blood urea nitrogen, creatinine, potassium, hemoglobin, and red blood cell were distinctive between the clusters. Cluster Three presented the highest blood products transfusion rate (19.8%), followed by Cluster One (15.5%) and cluster Two (9.3%), which was significantly different. Hemodialysis was more frequently provided to Cluster Three while bronchoscopy was done to Cluster One and Two. Cluster Three showed the highest mortality (30.4%), which was more than two-fold compared to Cluster One (14.1%) and Two (12.2%).
Three subgroups were identified and their clinical characteristics were compared. These findings may be useful to anticipate treatment strategies and probable outcomes of ICU patients. Unsupervised machine learning may enable ICU multi-dimensional data to be organized and to make sense of the data.
识别亚组可能有助于了解重症监护病房(ICU)患者的临床特征。本研究的目的是应用无监督机器学习方法对ICU患者数据进行分析,以发现其中的亚组;并研究这些亚组的临床特征、在ICU住院期间所采取的治疗措施以及出院情况。
采用K均值聚类方法,以1503例观察对象和9种实验室检查结果作为特征。
从这一特定人群中识别出三个聚类。各聚类之间血尿素氮、肌酐、钾、血红蛋白和红细胞存在差异。聚类三的血液制品输注率最高(19.8%),其次是聚类一(15.5%)和聚类二(9.3%),差异有统计学意义。聚类三接受血液透析的频率更高,而聚类一和聚类二接受支气管镜检查。聚类三的死亡率最高(30.4%),是聚类一(14.1%)和聚类二(12.2%)的两倍多。
识别出三个亚组并比较了它们的临床特征。这些发现可能有助于预测ICU患者的治疗策略和可能的预后。无监督机器学习可以使ICU的多维数据得到整理并理解这些数据。