A comprehensive evaluation for the prediction of mortality in intensive care units with LSTM networks: patients with cardiovascular disease

Biomed Tech (Berl). 2020 Aug 27;65(4):435-446. doi: 10.1515/bmt-2018-0206.

Abstract

Intensive care units (ICUs) are responsible for generating a wealth of useful data in the form of electronic health records. We aimed to build a mortality prediction model on a Medical Information Mart for Intensive Care (MIMIC-III) database and to assess whether the use of deep learning techniques like long short-term memory (LSTM) can effectively utilize the temporal relations among clinical variables. The models were built on clinical variable dynamics of the first 48 h of ICU admission of 12,550 records from the MIMIC-III database. A total of 36 variables including 33 time series variables and three static variables were used for the prediction. We present the application of LSTM and LSTM attention (LSTM-AT) model for mortality prediction with such a large number of clinical variables dataset. For training and validation purpose, we have used International Classification of Diseases, 9th edition (ICD-9) codes for extracting the patients with cardiovascular disease, and infections and parasitic disease, respectively. The effectiveness of the LSTM model is achieved over non-recurrent baseline models like naïve Bayes, logistic regression (LR), support vector machine and multilayer perceptron (MLP) by generating state of the art results (area under the curve [AUC], 0.852). Next, by providing attention at each time stamp, we developed a model, LSTM-AT, which exhibits even better performance (AUC, 0.876).

Keywords: LSTM; LSTM-AT; MIMIC-III; deep learning; machine learning; mortality prediction.

MeSH terms

  • Bayes Theorem
  • Cardiovascular Diseases / physiopathology*
  • Critical Care
  • Electronic Health Records
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Machine Learning
  • Neural Networks, Computer
  • Support Vector Machine