使用多尺度波形度量预测颅内高压
Forecasting intracranial hypertension using multi-scale waveform metrics
摘要：
目的：急性颅内高压是脑外伤后继发性脑损害的重要危险因素。高血压发作往往是反应性诊断，导致晚发现和干预计划的时间损失。提前几个小时预测关键事件的积极主动的方法可以帮助将注意力集中在有风险的患者身上。方法：我们开发了一个预测框架，可以预测未来8小时内急性颅内高压的发作。它联合使用脑自动调节指数，频谱能量和形态脉冲度量来描述患者的神经状态。通过计算信号度量来压缩一分钟的基础窗口，然后存储在多尺度历史中，从中导出生理特征。主要结果：在MIMIC-III波形数据库中，我们的模型提前8小时预测事件，报警召回率为90%，精确度为30.3%，在文献的两个基线基础上有所改进。我们发现，来自高频波形的特征大大提高了预测性能，超过了低频时间序列的简单统计摘要，三个特征类中的每一个都有助于提高性能。纳入长达8小时的长期病史尤为重要。意义：我们的研究结果强调了神经重症监护室高频波形中所含信息的重要性。他们可以激发未来对高血压前模式的研究，并为受伤大脑中的关键事件设计新的警报算法。
英文摘要：
Objective: Acute intracranial hypertension is an important risk factor of secondary brain damage after traumatic brain injury. Hypertensive episodes are often diagnosed reactively, leading to late detection and lost time for intervention planning. A pro-active approach that predicts critical events several hours ahead of time could assist in directing attention to patients at risk. Approach: We developed a prediction framework that forecasts onsets of acute intracranial hypertension in the next 8 hours. It jointly uses cerebral auto-regulation indices, spectral energies and morphological pulse metrics to describe the neurological state of the patient. One-minute base windows were compressed by computing signal metrics, and then stored in a multi-scale history, from which physiological features were derived. Main results: Our model predicted events up to 8 hours in advance with alarm recall rates of 90% at a precision of 30.3% in the MIMIC-III waveform database, improving upon two baselines from the literature. We found that features derived from high-frequency waveforms substantially improved the prediction performance over simple statistical summaries of low-frequency time series, and each of the three feature classes contributed to the performance gain. The inclusion of long-term history up to 8 hours was especially important. Significance: Our results highlight the importance of information contained in high-frequency waveforms in the neurological intensive care unit. They could motivate future studies on pre-hypertensive patterns and the design of new alarm algorithms for critical events in the injured brain.
机构、总结、中文摘要均由AI分析而来，可能存在错误，请以论文正文为准。
