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使用门控循环单元网络预测血流动力学和肺功能失代偿。

Using Gated Recurrent Unit Networks for the Prediction of Hemodynamic and Pulmonary Decompensation.

出版信息

Annu Int Conf IEEE Eng Med Biol Soc. 2022 Jul;2022:4584-4589. doi: 10.1109/EMBC48229.2022.9871500.

Abstract

This paper presents a new medical severity scoring system, used to assess the risk of hemodynamic and pulmonary decompensation for patients being treated in intensive care units. The score presented here includes drug circulatory support and ventilation mode data for the evaluation of the patient's biosignals and laboratory values. It is shown that Gated Recurrent Unit-based neural networks are able to predict the maximal severity class within a 24 hour prediction time-frame (hemodynamic: 0.85 AUROC / pulmonary: 0.9 AUROC), and can estimate the underlying decompensation score for prediction times of up to 24 hours with mean errors of 6.3% of the maximal possible pulmonary, and 9.6% of the hemodynamic score. These results are based on 60h observation period. Clinical Relevance- Hemodynamic and pulmonary decom-pensation are life threatening dynamic events that can lead to death of patients. Early detection of these incidents is essential in order to intervene therapeutically and to improve survival chances. In everyday intensive care physicians are confronted with a vast number of laboratory values and vital parameters. There is a risk that early stages of hemodynamic and pulmonary decompensation are misjudged. The implementation of robust warning systems could support physicians in detecting these critical events and initiate therapeutical intervention in time which would achieve significant reduction of patient mortality.

摘要

本文提出了一种新的医学严重程度评分系统,用于评估重症监护病房患者发生血流动力学和肺部失代偿的风险。这里提出的评分包括药物循环支持和通气模式数据,用于评估患者的生物信号和实验室值。结果表明,基于门控循环单元的神经网络能够在 24 小时预测时间内预测最大严重程度类别(血流动力学:0.85 AUROC/肺部:0.9 AUROC),并且可以在最长 24 小时的预测时间内估计潜在的失代偿评分,最大可能的肺部和血流动力学评分的平均误差分别为 6.3%和 9.6%。这些结果基于 60 小时的观察期。临床相关性-血流动力学和肺部失代偿是危及生命的动态事件,可导致患者死亡。早期发现这些事件对于进行治疗干预和提高生存机会至关重要。在日常重症监护中,医生面临着大量的实验室值和生命参数。存在误判血流动力学和肺部失代偿早期阶段的风险。实施稳健的预警系统可以帮助医生及时发现这些关键事件并进行治疗干预,从而显著降低患者死亡率。

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