Schwager Emma, Liu Xinggang, Nabian Mohsen, Feng Ting, French Robin MacDonald, Amelung Pam, Atallah Louis, Badawi Omar
Philips, Cambridge, Massachusetts, United States of America.
Johnson and Johnson, Rockville, Maryland, United States of America.
PLOS Digit Health. 2023 Sep 13;2(9):e0000289. doi: 10.1371/journal.pdig.0000289. eCollection 2023 Sep.
Predicting the duration of ventilation in the ICU helps in assessing the risk of ventilator-induced lung injury, ensuring sufficient oxygenation, and optimizing resource allocation. Prior models provided a prediction of total duration without distinguishing between invasive and non-invasive ventilation. This work proposes two independent gradient boosting regression models for predicting the duration of invasive and non-invasive ventilation based on commonly available ICU features. These models are trained on 2.6 million patient stays across 350 US hospitals between 2010 to 2019. The mean absolute error (MAE) for the prediction of duration was 2.08 days for invasive ventilation and 0.36 days for non-invasive ventilation. The total ventilation duration predicted by our model had MAE of 2.38 days, which outperformed the gold standard (APACHE) with MAE of 3.02 days. The feature importance analysis of the trained models showed that, for invasive ventilation, high average heart rate, diagnosis of respiratory infection and admissions from locations other than the operating room were associated with longer ventilation durations. For non-invasive ventilation, higher respiratory rates and having any GCS measurement were associated with longer durations.
预测重症监护病房(ICU)的通气时长有助于评估呼吸机相关性肺损伤的风险、确保充足的氧合以及优化资源分配。先前的模型可预测总时长,但未区分有创通气和无创通气。这项研究提出了两个独立的梯度提升回归模型,用于基于常见的ICU特征预测有创通气和无创通气的时长。这些模型在2010年至2019年期间对美国350家医院的260万例患者住院数据进行了训练。有创通气时长预测的平均绝对误差(MAE)为2.08天,无创通气为0.36天。我们模型预测的总通气时长的MAE为2.38天,优于金标准(急性生理与慢性健康状况评分系统(APACHE)),其MAE为3.02天。对训练模型的特征重要性分析表明,对于有创通气,平均心率高、呼吸道感染诊断以及非手术室地点入院与通气时长较长相关。对于无创通气,呼吸频率较高以及进行过任何格拉斯哥昏迷量表(GCS)测量与通气时长较长相关。