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利用电子健康记录中的结构化和非结构化数据构建重症监护病房患者30天再入院预测模型。

Building Prediction Models for 30-Day Readmissions Among ICU Patients Using Both Structured and Unstructured Data in Electronic Health Records.

作者信息

Moerschbacher Alex, He Zhe

机构信息

School of Information, Florida State University, Tallahassee, United States.

出版信息

Proceedings (IEEE Int Conf Bioinformatics Biomed). 2023 Dec;2023:4368-4373. doi: 10.1109/bibm58861.2023.10385612. Epub 2024 Jan 18.

Abstract

ICU readmissions are associated with poor outcomes for patients and poor performance of hospitals. Patients who are readmitted have an increased risk of in-hospital deaths; hospitals with a higher read-mission rate have a reduced profitability, due to an increase in cost and reduced payments from Medicare and Medicaid programs. Predicting a patient's likelihood of being readmitted to the ICU can help reduce early discharges, the risk of in-hospital deaths, and help in-crease profitability. In this study, we built and evaluated multiple machine learning models to predict 30-day readmission rates of ICU patients in the MIMIC-III database. We used both the structured data including demographics, laboratory tests, comorbidities, and unstructured discharge summaries as the predictors and evaluated different combinations of features. The best performing model in this study Logistic Regression achieved an AUROC of 75.7%. This study shows the potential of leveraging machine learning and deep learning for predicting ICU readmissions.

摘要

重症监护病房(ICU)再入院与患者的不良预后以及医院的不佳表现相关。再入院的患者院内死亡风险增加;再入院率较高的医院盈利能力下降,原因是成本增加以及医疗保险和医疗补助计划支付减少。预测患者再次入住ICU的可能性有助于减少过早出院、降低院内死亡风险并提高盈利能力。在本研究中,我们构建并评估了多个机器学习模型,以预测MIMIC-III数据库中ICU患者的30天再入院率。我们将包括人口统计学、实验室检查、合并症在内的结构化数据以及非结构化出院小结都用作预测指标,并评估了不同的特征组合。本研究中表现最佳的模型——逻辑回归,其曲线下面积(AUROC)达到了75.7%。这项研究展示了利用机器学习和深度学习预测ICU再入院情况的潜力。

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Analysing repeated hospital readmissions using data mining techniques.使用数据挖掘技术分析反复住院情况。
Health Syst (Basingstoke). 2017 Nov 7;7(2):120-134. doi: 10.1080/20476965.2017.1390635. eCollection 2018.
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A comparison of models for predicting early hospital readmissions.预测早期医院再入院的模型比较。
J Biomed Inform. 2015 Aug;56:229-38. doi: 10.1016/j.jbi.2015.05.016. Epub 2015 Jun 1.
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Hospital readmissions reduction program.医院再入院率降低计划。
Circulation. 2015 May 19;131(20):1796-803. doi: 10.1161/CIRCULATIONAHA.114.010270.

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