A predictive model of mortality in acute renal failure in the critical patient

Background and Aims: Patients with Acute Renal Failure (ARF) have a high risk of mortality, especially those who enter the Intensive Care Unit (ICU). In this population, predictive models of mortality on prognostic scales, such as SAPS-II (Simplified Acute Physiology Score II), linearly relate risk...

Descripción completa

Detalles Bibliográficos
Autores: Ibeas, Jose|||0000-0002-1292-7271, Lleal, Elia, Macias Toro, Edwar Hernando|||0000-0001-5568-9237, Rubiella, Carolina|||0000-0002-6496-8710, Morell, Antoni|||0000-0003-2249-8594, Serrano, Javier|||0000-0003-1235-2145, Lopez Vicario, Jose|||0000-0002-3574-4697
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:273483
Acceso en línea:https://ddd.uab.cat/record/273483
https://dx.doi.org/urn:doi:10.1093/ndt/gfaa139.SO019
Access Level:acceso abierto
Palabra clave:SDG 3 - Good Health and Well-being
Descripción
Sumario:Background and Aims: Patients with Acute Renal Failure (ARF) have a high risk of mortality, especially those who enter the Intensive Care Unit (ICU). In this population, predictive models of mortality on prognostic scales, such as SAPS-II (Simplified Acute Physiology Score II), linearly relate risk factors without taking into account the complex relationship's variables can have. There are models where Machine Learning (ML) techniques have been used, but there is still room for improvement. The implementation of deep artificial neural networks (DANN) can be challenging. The literature models, using SAPS-II report an accuracy, f1 and ROC area (receiver operating curve) in ranges of 0.538-0.621, 0.333-0.377 and 0.781-0.809 respectively. The best results with ML are improved in neural networks of a hidden layer or random forest, being the best performance in the latter: accuracy 0.715-0.741, F1 0.449-0.470 and ROC between 0.862-0.870. The aim is to evaluate and improve the predictive capacity of ML techniques for the prediction of mortality in patients with ARF admitted to the ICU, through the use of the open database MIMIC-III (Medical Information Martfor Intensive Care III). Method: Design: Retrospective analysis of historical cooperation of 20,928 patients with ARF from Beth Israel Deaconess (Boston), from 2001 to 2012. Method: ML algorithm based on DANN. Creation of a model to predict in-hospital mortality after discharge from the ICU with the variables of the first 24 hours after admission to the ICU. To evaluate the robustness of the model has been performed cross-validation by separating the samples into different combinations of training and test data (k-folds). The unavailable variables haematological with means extracted from the training set of the respective fold. The DANN trained with the complex relationship's variables folds, two hidden layers of 75 and 40 neurons respectively. Inclusion criteria:.