Development and validation of dynamic prediction models using vital signs time series data for fatal massive hemorrhage in trauma
10.11855/j.issn.0577-7402.1273.2023.0427
- VernacularTitle:基于生命体征时序数据的创伤致死性大出血伤情动态预测模型开发及验证
- Author:
Cheng-Yu GUO
1
,
2
;
Ming-Hui GONG
;
Qiao-Chu SHEN
;
Hui HAN
;
Ruo-Lin WANG
;
Hong-Liang ZHANG
;
Jun-Kang WANG
;
Chun-Ping LI
;
Tan-Shi LI
Author Information
1. 南开大学医学院,天津 300071
2. 解放军总医院第一医学中心急诊科,北京 100853
- Keywords:
wounds and injuries;
massive hemorrhage;
machine learning;
assistant diagnosis
- From:
Medical Journal of Chinese People's Liberation Army
2024;49(6):629-635
- CountryChina
- Language:Chinese
-
Abstract:
Objective To establish a dynamic prediction model of fatal massive hemorrhage in trauma based on the vital signs time series data and machine learning algorithms.Methods Retrospectively analyze the vital signs time series data of 7522 patients with trauma in the Medical Information Mart for Intensive Care-Ⅳ(MIMIC-Ⅳ)database from 2008 to 2019.According to the occurrence of posttraumatic fatal massive hemorrhage,the patients were divided into two groups:fatal massive hemorrhage group(n=283)and non-fatal massive hemorrhage group(n=7239).Six machine learning algorithms,including logistic regression(LR),support vector machine(SVM),random forests(RF),adaptive boosting(AdaBoost),gated recurrent unit(GRU),and GRU-D were used to develop a dynamic prediction models of fatal massive hemorrhage in trauma.The probability of fatal massive hemorrhage in the following 1,2,and 3 h was dynamically predicted.The performance of the models was evaluated by accuracy,sensitivity,specificity,positive predictive value,negative predictive value,Youden index,and area under receiver operating characteristic curve(AUC).The models were externally validated based on the trauma database of the Chinese PLA General Hospital.Results In the MIMIC-Ⅳ database,the set of dynamic prediction models based on the GRU-D algorithm was the best.The AUC for predicting fatal major bleeding in the next 1,2,and 3 h were 0.946±0.029,0.940±0.032,and 0.943±0.034,respectively,and there was no significant difference(P=0.905).In the trauma dataset,GRU-D model achieved the best external validation effect.The AUC for predicting fatal major bleeding in the next 1,2,and 3 h were 0.779±0.013,0.780±0.008,and 0.778±0.009,respectively,and there was no significant difference(P=0.181).This set of models was deployed in a public web calculator and hospital emergency department information system,which is convenient for the public and medical staff to use and validate the model.Conclusion A set of dynamic prediction models has been successfully developed and validated,which is greatly significant for the early diagnosis and dynamic prediction of fatal massive hemorrhage in trauma.
