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使用递归神经网络预测心血管重症监护病房的再入院情况。

Predicting readmission to the cardiovascular intensive care unit using recurrent neural networks.

作者信息

Kessler Steven, Schroeder Dennis, Korlakov Sergej, Hettlich Vincent, Kalkhoff Sebastian, Moazemi Sobhan, Lichtenberg Artur, Schmid Falko, Aubin Hug

机构信息

Digital Health Lab Düsseldorf, University Hospital Düsseldorf, Düsseldorf, Germany.

Department of Cardiac Surgery, University Hospital Düsseldorf, Düsseldorf, Germany.

出版信息

Digit Health. 2023 Jan 9;9:20552076221149529. doi: 10.1177/20552076221149529. eCollection 2023 Jan-Dec.

Abstract

If a patient can be discharged from an intensive care unit (ICU) is usually decided by the treating physicians based on their clinical experience. However, nowadays limited capacities and growing socioeconomic burden of our health systems increase the pressure to discharge patients as early as possible, which may lead to higher readmission rates and potentially fatal consequences for the patients. Therefore, here we present a long short-term memory-based deep learning model (LSTM) trained on time series data from Medical Information Mart for Intensive Care (MIMIC-III) dataset to assist physicians in making decisions if patients can be safely discharged from cardiovascular ICUs. To underline the strengths of our LSTM we compare its performance with a logistic regression model, a random forest, extra trees, a feedforward neural network and with an already known, more complex LSTM as well as an LSTM combined with a convolutional neural network. The results of our evaluation show that our LSTM outperforms most of the above models in terms of area under receiver operating characteristic curve. Moreover, our LSTM shows the best performance with respect to the area under precision-recall curve. The deep learning solution presented in this article can help physicians decide on patient discharge from the ICU. This may not only help to increase the quality of patient care, but may also help to reduce costs and to optimize ICU resources. Further, the presented LSTM-based approach may help to improve existing and develop new medical machine learning prediction models.

摘要

患者是否可以从重症监护病房(ICU)出院通常由主治医生根据他们的临床经验来决定。然而,如今我们医疗系统有限的容量和不断增加的社会经济负担加大了尽早让患者出院的压力,这可能导致更高的再入院率,并给患者带来潜在的致命后果。因此,在此我们展示一种基于长短期记忆的深度学习模型(LSTM),该模型是根据重症监护医学信息集市(MIMIC-III)数据集的时间序列数据进行训练的,以协助医生做出关于患者是否可以安全地从心血管ICU出院的决策。为了突出我们的LSTM的优势,我们将其性能与逻辑回归模型、随机森林、极端随机树、前馈神经网络以及一个已知的、更复杂的LSTM以及一个结合了卷积神经网络的LSTM进行比较。我们的评估结果表明,在受试者工作特征曲线下面积方面,我们的LSTM优于上述大多数模型。此外,在精确率-召回率曲线下面积方面,我们的LSTM表现最佳。本文提出的深度学习解决方案可以帮助医生决定患者是否从ICU出院。这不仅有助于提高患者护理质量,还可能有助于降低成本并优化ICU资源。此外,所提出的基于LSTM的方法可能有助于改进现有的并开发新的医疗机器学习预测模型。

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