Cargando…

Predicting Cardiac Arrest in Children with Heart Disease: A Novel Machine Learning Algorithm

Background: Children with congenital and acquired heart disease are at a higher risk of cardiac arrest compared to those without heart disease. Although the monitoring of cardiopulmonary resuscitation quality and extracorporeal resuscitation technologies have advanced, survival after cardiac arrest...

Descripción completa

Detalles Bibliográficos
Autores principales: Yu, Priscilla, Skinner, Michael, Esangbedo, Ivie, Lasa, Javier J., Li, Xilong, Natarajan, Sriraam, Raman, Lakshmi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10095110/
https://www.ncbi.nlm.nih.gov/pubmed/37048811
http://dx.doi.org/10.3390/jcm12072728
_version_ 1785024003992190976
author Yu, Priscilla
Skinner, Michael
Esangbedo, Ivie
Lasa, Javier J.
Li, Xilong
Natarajan, Sriraam
Raman, Lakshmi
author_facet Yu, Priscilla
Skinner, Michael
Esangbedo, Ivie
Lasa, Javier J.
Li, Xilong
Natarajan, Sriraam
Raman, Lakshmi
author_sort Yu, Priscilla
collection PubMed
description Background: Children with congenital and acquired heart disease are at a higher risk of cardiac arrest compared to those without heart disease. Although the monitoring of cardiopulmonary resuscitation quality and extracorporeal resuscitation technologies have advanced, survival after cardiac arrest in this population has not improved. Cardiac arrest prevention, using predictive algorithms with machine learning, has the potential to reduce cardiac arrest rates. However, few studies have evaluated the use of these algorithms in predicting cardiac arrest in children with heart disease. Methods: We collected demographic, laboratory, and vital sign information from the electronic health records (EHR) of all the patients that were admitted to a single-center pediatric cardiac intensive care unit (CICU), between 2010 and 2019, who had a cardiac arrest during their CICU admission, as well as a comparator group of randomly selected non-cardiac-arrest controls. We compared traditional logistic regression modeling against a novel adaptation of a machine learning algorithm (functional gradient boosting), using time series data to predict the risk of cardiac arrest. Results: A total of 160 unique cardiac arrest events were matched to non-cardiac-arrest time periods. Using 11 different variables (vital signs and laboratory values) from the EHR, our algorithm’s peak performance for the prediction of cardiac arrest was at one hour prior to the cardiac arrest (AUROC of 0.85 [0.79,0.90]), a performance that was similar to our previously published multivariable logistic regression model. Conclusions: Our novel machine learning predictive algorithm, which was developed using retrospective data that were collected from the EHR and predicted cardiac arrest in the children that were admitted to a single-center pediatric cardiac intensive care unit, demonstrated a performance that was similar to that of a traditional logistic regression model. While these results are encouraging, future research, including prospective validations with multicenter data, is warranted prior to the implementation of this algorithm as a real-time clinical decision support tool.
format Online
Article
Text
id pubmed-10095110
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100951102023-04-13 Predicting Cardiac Arrest in Children with Heart Disease: A Novel Machine Learning Algorithm Yu, Priscilla Skinner, Michael Esangbedo, Ivie Lasa, Javier J. Li, Xilong Natarajan, Sriraam Raman, Lakshmi J Clin Med Article Background: Children with congenital and acquired heart disease are at a higher risk of cardiac arrest compared to those without heart disease. Although the monitoring of cardiopulmonary resuscitation quality and extracorporeal resuscitation technologies have advanced, survival after cardiac arrest in this population has not improved. Cardiac arrest prevention, using predictive algorithms with machine learning, has the potential to reduce cardiac arrest rates. However, few studies have evaluated the use of these algorithms in predicting cardiac arrest in children with heart disease. Methods: We collected demographic, laboratory, and vital sign information from the electronic health records (EHR) of all the patients that were admitted to a single-center pediatric cardiac intensive care unit (CICU), between 2010 and 2019, who had a cardiac arrest during their CICU admission, as well as a comparator group of randomly selected non-cardiac-arrest controls. We compared traditional logistic regression modeling against a novel adaptation of a machine learning algorithm (functional gradient boosting), using time series data to predict the risk of cardiac arrest. Results: A total of 160 unique cardiac arrest events were matched to non-cardiac-arrest time periods. Using 11 different variables (vital signs and laboratory values) from the EHR, our algorithm’s peak performance for the prediction of cardiac arrest was at one hour prior to the cardiac arrest (AUROC of 0.85 [0.79,0.90]), a performance that was similar to our previously published multivariable logistic regression model. Conclusions: Our novel machine learning predictive algorithm, which was developed using retrospective data that were collected from the EHR and predicted cardiac arrest in the children that were admitted to a single-center pediatric cardiac intensive care unit, demonstrated a performance that was similar to that of a traditional logistic regression model. While these results are encouraging, future research, including prospective validations with multicenter data, is warranted prior to the implementation of this algorithm as a real-time clinical decision support tool. MDPI 2023-04-06 /pmc/articles/PMC10095110/ /pubmed/37048811 http://dx.doi.org/10.3390/jcm12072728 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yu, Priscilla
Skinner, Michael
Esangbedo, Ivie
Lasa, Javier J.
Li, Xilong
Natarajan, Sriraam
Raman, Lakshmi
Predicting Cardiac Arrest in Children with Heart Disease: A Novel Machine Learning Algorithm
title Predicting Cardiac Arrest in Children with Heart Disease: A Novel Machine Learning Algorithm
title_full Predicting Cardiac Arrest in Children with Heart Disease: A Novel Machine Learning Algorithm
title_fullStr Predicting Cardiac Arrest in Children with Heart Disease: A Novel Machine Learning Algorithm
title_full_unstemmed Predicting Cardiac Arrest in Children with Heart Disease: A Novel Machine Learning Algorithm
title_short Predicting Cardiac Arrest in Children with Heart Disease: A Novel Machine Learning Algorithm
title_sort predicting cardiac arrest in children with heart disease: a novel machine learning algorithm
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10095110/
https://www.ncbi.nlm.nih.gov/pubmed/37048811
http://dx.doi.org/10.3390/jcm12072728
work_keys_str_mv AT yupriscilla predictingcardiacarrestinchildrenwithheartdiseaseanovelmachinelearningalgorithm
AT skinnermichael predictingcardiacarrestinchildrenwithheartdiseaseanovelmachinelearningalgorithm
AT esangbedoivie predictingcardiacarrestinchildrenwithheartdiseaseanovelmachinelearningalgorithm
AT lasajavierj predictingcardiacarrestinchildrenwithheartdiseaseanovelmachinelearningalgorithm
AT lixilong predictingcardiacarrestinchildrenwithheartdiseaseanovelmachinelearningalgorithm
AT natarajansriraam predictingcardiacarrestinchildrenwithheartdiseaseanovelmachinelearningalgorithm
AT ramanlakshmi predictingcardiacarrestinchildrenwithheartdiseaseanovelmachinelearningalgorithm