A hypotensive episode predictor for intensive care based on heart rate and blood pressure time series

Abstract

In the intensive care unit (ICU), prompt therapeutic intervention to hypotensive episodes (HEs) is a critical task. Advance alerts that can prospectively identify patients at risk of developing an HE in the next few hours would be of considerable clinical value. In this study, we developed an automated, artificial neural network HE predictor based on heart rate and blood pressure time series from the MIMIC II database. The gap between prediction time and the onset of the 30-minute target window was varied from 1 to 4 hours. A 30-minute observation window preceding the prediction time provided input information to the predictor. While individual gap sizes were evaluated independently, weighted posterior probabilities based on different gap sizes were also investigated. The results showed that prediction performance degraded as gap size increased and the weighting scheme induced negligible performance improvement. Despite low positive predictive values, the best mean area under ROC curve was 0.934.