Mortality prediction using medical time series on TBI patients

Abstract

Background and objectiveTraumatic Brain Injury (TBI) is one of the leading causes of injury-related mortality in the world, with severe cases reaching mortality rates of 30-40%. It is highly heterogeneous both in causes and consequences making more complex the medical interpretation and prognosis. Gathering clinical, demographic, and laboratory data to perform a prognosis requires time and skill in several clinical specialties. Artificial intelligence (AI) methods can take advantage of existing data by performing helpful predictions and guiding physicians toward a better prognosis and, consequently, better healthcare. The objective of this work was to develop learning models and evaluate their capability of predicting the mortality of TBI. The predictive model would allow the early assessment of the more serious cases and scarce medical resources can be pointed toward the patients who need them most. MethodsLong Short Term Memory (LSTM) and Transformer architectures were tested and compared in performance, coupled with data imbalance, missing data, and feature selection strategies. From the Medical Information Mart for Intensive Care III (MIMIC-III) dataset, a cohort of TBI patients was selected and an analysis of the first 48 hours of multiple time series sequential variables was done to predict hospital mortality. ResultsThe best performance was obtained with the Transformer architecture, achieving an AUC of 0.907 with the larger group of features and trained with class proportion class weights and binary cross entropy loss. ConclusionsUsing the time series sequential data, LSTM and Transformers proved to be both viable options for predicting TBI hospital mortality in 48 hours after admission. Overall, using sequential deep learning models with time series data to predict TBI mortality is viable and can be used as a helpful indicator of the well-being of patients.