Prediction model of in-hospital cardiac arrest using machine learning in the early phase of hospitalization.

The Kaohsiung journal of medical sciences Pub Date : 2024-11-01 Epub Date: 2024-09-25 DOI:10.1002/kjm2.12895
Wei-Tsung Wu, Chew-Teng Kor, Ming-Chung Chou, Hui-Min Hsieh, Wan-Chih Huang, Wei-Ling Huang, Shu-Yen Lin, Ming-Ru Chen, Tsung-Hsien Lin
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Abstract

In hospitals, the deterioration of a patient's condition leading to death is often preceded by physiological abnormalities in the hours to days beforehand. Several risk-scoring systems have been developed to identify patients at risk of major adverse events; however, such systems often exhibit low sensitivity and specificity. To identify the risk factors associated with in-hospital cardiac arrest (IHCA), we conducted a retrospective cohort study at a tertiary medical center in Taiwan. Four machine learning algorithms were employed to identify the factors most predictive of IHCA. The support vector machine model was discovered to be the most effective at predicting IHCA. The ten most critical physiological parameters at 8 h prior to the event were pulse rate, age, white blood cell count, lymphocyte count, body temperature, body mass index, systolic and diastolic blood pressure, platelet count, and use of central nervous system-active medication. Using these parameters, we can enhance early warning and rapid response systems in our hospital, potentially reducing the incidence of IHCA in clinical practice.

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在住院初期利用机器学习建立院内心脏骤停预测模型。
在医院里,病人病情恶化导致死亡之前的几小时到几天内往往会出现生理异常。目前已开发出几种风险评分系统来识别有发生重大不良事件风险的病人,但这些系统的灵敏度和特异性往往很低。为了确定与院内心脏骤停(IHCA)相关的风险因素,我们在台湾的一家三级医疗中心进行了一项回顾性队列研究。我们采用了四种机器学习算法来确定最能预测院内心脏骤停的因素。结果发现,支持向量机模型在预测 IHCA 方面最为有效。事件发生前 8 小时最关键的十个生理参数是脉搏、年龄、白细胞计数、淋巴细胞计数、体温、体重指数、收缩压和舒张压、血小板计数以及中枢神经系统活性药物的使用情况。利用这些参数,我们可以加强医院的早期预警和快速反应系统,从而在临床实践中降低 IHCA 的发生率。
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