Zarkesh Mohammad Reza, Moradi Raheleh, Orooji Azam
Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Neonatology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehra, Iran.
Acute Crit Care. 2022 Aug;37(3):438-453. doi: 10.4266/acc.2021.01501. Epub 2022 Aug 29.
Anticipating the need for at-birth cardiopulmonary resuscitation (CPR) in neonates is very important and complex. Timely identification and rapid CPR for neonates in the delivery room significantly reduce mortality and other neurological disabilities. The aim of this study was to create a prediction system for identifying the need for at-birth CPR in neonates based on Machine Learning (ML) algorithms.
In this study, 3,882 neonatal medical records were retrospectively reviewed. A total of 60 risk factors was extracted, and five ML algorithms of J48, Naïve Bayesian, multilayer perceptron, support vector machine (SVM), and random forest were compared to predict the need for at-birth CPR in neonates. Two types of resuscitation were considered: basic and advanced CPR. Using five feature selection algorithms, features were ranked based on importance, and important risk factors were identified using the ML algorithms.
To predict the need for at-birth CPR in neonates, SVM using all risk factors reached 88.43% accuracy and F-measure of 88.4%, while J48 using only the four first important features reached 90.89% accuracy and F-measure of 90.9%. The most important risk factors were gestational age, delivery type, presentation, and mother's addiction.
The proposed system can be useful in predicting the need for CPR in neonates in the delivery room.
预测新生儿出生时心肺复苏(CPR)的需求非常重要且复杂。在产房及时识别并对新生儿进行快速心肺复苏可显著降低死亡率和其他神经功能障碍。本研究的目的是基于机器学习(ML)算法创建一个预测系统,以识别新生儿出生时心肺复苏的需求。
在本研究中,对3882份新生儿病历进行了回顾性分析。共提取了60个风险因素,并比较了J48、朴素贝叶斯、多层感知器、支持向量机(SVM)和随机森林这五种机器学习算法,以预测新生儿出生时心肺复苏的需求。考虑了两种复苏类型:基本心肺复苏和高级心肺复苏。使用五种特征选择算法,根据重要性对特征进行排序,并使用机器学习算法识别重要风险因素。
为预测新生儿出生时心肺复苏的需求,使用所有风险因素的支持向量机准确率达到88.43%,F值为88.4%,而仅使用四个最重要特征的J48准确率达到90.89%,F值为90.9%。最重要的风险因素是胎龄、分娩方式、胎位和母亲成瘾情况。
所提出的系统可用于预测产房新生儿心肺复苏的需求。