Lu Xiao, Xu Hongli, Dong Wei, Xin Yi, Zhu Jiang, Lin Xingkang, Zhuang Yan, Che Hebin, Li Qin, He Kunlun
Medical Innovation Research Department of PLA General Hospital, Haidian District, No.28 Fuxing Road, Beijing, 100853 China.
Department of Biomedical Engineering, School of Life Science, Beijing Institute of Technology, Beijing, 100081 China.
J Healthc Inform Res. 2025 Mar 6;9(2):174-190. doi: 10.1007/s41666-025-00192-x. eCollection 2025 Jun.
Abnormal serum sodium levels are a common and severe complication in stroke patients, significantly increasing mortality risk and prolonging ICU stays. Accurate real-time prediction of serum sodium fluctuations is crucial for optimizing clinical interventions. However, existing predictive models face limitations in handling complex dynamic features and long time series data, making them less effective in guiding individualized treatment. To address this challenge, this study developed a deep learning model based on a multi-head attention mechanism to enable real-time prediction of serum sodium concentrations and provide personalized intervention recommendations for ICU stroke patients. This study utilized publicly available MIMIC-III ( = 2346) and MIMIC-IV ( = 896) datasets, extracting time series data from 10 key clinical indicators closely associated with serum sodium levels. To address the complexity of long time series data, a moving sliding window sub-sampling segmentation method was employed, effectively transforming extensive sequences into more manageable inputs while preserving critical temporal dependencies. By leveraging advanced mathematical modeling, meaningful insights were extracted from sparse and irregular time series data. The resulting time-feature fusion multi-head attention (TFF-MHA) model underwent rigorous validation using public datasets and demonstrated superior performance in predicting both serum sodium values and corresponding intervention measures compared to existing models. This study contributes to the field of healthcare informatics by introducing an innovative, data-driven approach for dynamic serum sodium prediction and intervention recommendation, providing a valuable clinical decision-support tool for optimizing sodium management strategies in critically ill stroke patients.
血清钠水平异常是中风患者常见且严重的并发症,显著增加死亡风险并延长重症监护病房(ICU)住院时间。准确实时预测血清钠波动对于优化临床干预至关重要。然而,现有的预测模型在处理复杂动态特征和长时间序列数据方面存在局限性,使其在指导个体化治疗方面效果欠佳。为应对这一挑战,本研究开发了一种基于多头注意力机制的深度学习模型,以实现对血清钠浓度的实时预测,并为ICU中风患者提供个性化干预建议。本研究利用公开可用的MIMIC - III(n = 2346)和MIMIC - IV(n = 896)数据集,从与血清钠水平密切相关的10个关键临床指标中提取时间序列数据。为解决长时间序列数据的复杂性,采用了移动滑动窗口子采样分割方法,有效将长序列转换为更易于管理的输入,同时保留关键的时间依赖性。通过利用先进的数学建模,从稀疏和不规则的时间序列数据中提取有意义的见解。所得的时间特征融合多头注意力(TFF - MHA)模型使用公共数据集进行了严格验证,与现有模型相比,在预测血清钠值和相应干预措施方面均表现出卓越性能。本研究通过引入创新的数据驱动方法进行动态血清钠预测和干预推荐,为医疗保健信息学领域做出了贡献,为优化重症中风患者的钠管理策略提供了有价值的临床决策支持工具。