一个基于深度学习的动态模型,用于预测术后患者急性损伤风险严重程度
Esra Adiyeke1, Yuanfang Ren1, Matthew M Ruppert1
1University of Florida Intelligent Critical Care Center, Gainesville, FL; Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL.
Surgery
|June 14, 2023
概括
一个新的复发性神经网络模型准确地预测了术后急性损伤 (AKI) 风险. 这种人工智能工具通过提供连续和动态的AKI预测来增强患者护理,改善结果.
科学领域:
- 人工智能在医学中的应用
- 腎臟病學 (nephrology) 是一種醫學.
- 手术患者监测手术患者监测
背景情况:
- 手术后的急性损伤 (AKI) 影响了10-30%的手术患者.
- AKI与医疗保健成本增加,慢性病和死亡率有关.
- 准确及时预测AKI对于患者管理至关重要.
研究的目的:
- 开发和评估一个循环神经网络 (RNN) 模型,用于预测术后的AKI.
- 将RNN模型的性能与传统机器学习模型进行比较.
- 提高临床信任预测模型的可解释性.
主要方法:
- 利用了来自佛罗里达大学卫生部42906名手术患者 (2014-2021) 的数据.
- 开发了一个RNN模型,在24小时内预测AKI风险和阶段.
- 输入包括药物,生命体,实验室结果和历史数据;用于解释性的集成梯度.
主要成果:
- 20%的队列发生了术后的AKI.
- 与物流回归相比,RNN模型在预测所有AKI阶段方面表现出卓越的准确性.
- 曲线下的面积 (AUC) 对于RNN与逻辑回归:没有AKI (0.98与0.93),第一阶段 (0.95与0.81),第二阶段 (2/3) (0.99与0.96).
结论:
- 通过RNN进行时间处理,可以进行细粒度,动态和准确的AKI预测.
- 综合梯度框架提高了模型的可解释性,促进了临床采用.
- 这种人工智能驱动的方法有望改善术后患者的治疗结果.
相关概念视频
01:22Acute Kidney Injury I: Introduction
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Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
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01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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01:29Acute Kidney Injury II: Pathophysiology
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Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
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01:22Acute Kidney Injury VI: Nursing Management
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Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
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01:20Acute Kidney Injury V: Interprofessional Care
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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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01:29Acute Kidney Injury III: Clinical Manifestations
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Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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