对心力衰竭患者的入院优先考虑,这些患者有多种并发症
Rahul Awasthy1, Meetu Malhotra1, Michael L Seavers1
1Data Science, Harrisburg University of Science and Technology, Harrisburg, PA, United States.
Frontiers in digital health
|July 17, 2024
概括
这项研究引入了一种机器学习 (ML) 工具,用于优先考虑紧急护理中的心力衰竭 (HF) 患者. ML模型在识别高风险患者方面实现了超过97.8%的效率,以更好地分配资源.
科学领域:
- 医疗信息学 医疗信息学
- 医疗保健中的人工智能
- 临床决策支持系统 临床决策支持系统
背景情况:
- 急性心力衰竭 (HF) 管理需要有效的患者优先级,特别是伴随性疾病.
- 目前的紧急护理系统面临着快速评估和根据死亡风险对HF患者进行排名的挑战.
- 自动决策支持可以提高医疗保健的运营效率.
研究的目的:
- 开发一种使用机器学习 (ML) 的自动化患者优先级 (PP) 工具,用于紧急护理中的HF患者.
- 提高医疗保健提供者为急性HF患者提供服务的效率和有效性.
- 支持医疗保健工作人员优先考虑患有慢性病和并发病的HF患者.
主要方法:
- 应用机器学习模型到FysioNet数据集 (2016-2019) 中的齐贡第四人民医院的HF患者.
- 利用住院和死亡记录进行模型培训和验证.
- 将模型结果与HCUP马里兰州住院患者数据 (2014) 进行比较,以评估可概括性.
主要成果:
- 机器学习模型在识别高风险HF患者时表现出超过97.8%的效率和95%的特异性.
- 这些模型根据患者的死亡风险水平准确地对患者进行了排名.
- 该PP工具有效地支持HF患者管理的风险评估.
结论:
- 开发的基于ML的PP工具显著提高了紧急护理场所中HF患者的优先级.
- 这种方法支持有效地将资源分配给最迫切需要的患者.
- 这些发现表明,ML对于提高医疗保健效率和患者结果的更广泛的适用性.
相关概念视频
01:17Pathophysiology of Heart Failure
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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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01:22Heart Failure Drugs: β-Blockers
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β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
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01:22Heart Failure Drugs: Diuretics
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01:26Imbalances in Cardiac Output
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The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
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01:26Heart Failure Drugs: Inotropic Agents
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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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