scholarly journals Sentiment Analysis Based on the Nursing Notes on In-Hospital 28-Day Mortality of Sepsis Patients Utilizing the MIMIC-III Database

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Qiaoyan Gao ◽  
Dandan Wang ◽  
Pingping Sun ◽  
Xiaorong Luan ◽  
Wenfeng Wang
Keyword(s):  
Large Scale ◽  
Cox Model ◽  
Pathological Condition ◽  
Prognostic Index ◽  
Simplified Acute Physiology Score ◽  
Saps Ii ◽  
Death Time ◽  
Saps Ii Score ◽  
Cox Analysis ◽  
Mimic Iii

In medical visualization, nursing notes contain rich information about a patient’s pathological condition. However, they are not widely used in the prediction of clinical outcomes. With advances in the processing of natural language, information begins to be extracted from large-scale unstructured data like nursing notes. This study extracted sentiment information in nursing notes and explored its association with in-hospital 28-day mortality in sepsis patients. The data of patients and nursing notes were extracted from the MIMIC-III database. A COX proportional hazard model was used to analyze the relationship between sentiment scores in nursing notes and in-hospital 28-day mortality. Based on the COX model, the individual prognostic index (PI) was calculated, and then, survival was analyzed. Among eligible 1851 sepsis patients, 580 cases suffered from in-hospital 28-day mortality (dead group), while 1271 survived (survived group). Significant differences were shown between two groups in sentiment polarity, Simplified Acute Physiology Score II (SAPS-II) score, age, and intensive care unit (ICU) type (all P < 0.001 ). Multivariate COX analysis exhibited that sentiment polarity (HR: 0.499, 95% CI: 0.409-0.610, P < 0.001 ) and sentiment subjectivity (HR: 0.710, 95% CI: 0.559-0.902, P = 0.005 ) were inversely associated with in-hospital 28-day mortality, while the SAPS-II score (HR: 1.034, 95% CI: 1.029-1.040, P < 0.001 ) was positively correlated with in-hospital 28-day mortality. The median death time of patients with PI ≥ 0.561 was significantly earlier than that of patients with PI < 0.561 (13.5 vs. 49.8 days, P < 0.001 ). In conclusion, sentiments in nursing notes are associated with the in-hospital 28-day mortality and survival of sepsis patients.

Prognostic Factors for Neutropenic Patients Admitted to Intensive Care.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3900-3900
Author(s):  
Madalena Silva ◽  
Luisa Checa ◽  
Fatima Costa ◽  
Rui Moreno ◽  
Eduardo G. Silva ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Underlying Disease ◽  
Simplified Acute Physiology Score ◽  
Prognostic Impact ◽  
Saps Ii ◽  
Severity Scores ◽  
Saps Ii Score ◽  
Organ Failures ◽  
Neutropenic Patients

Abstract The admission of neutropenic patients (pts) to intensive care units (ICU) is controversial, especially when mechanical ventilation is required. Knowledge of the relative prognostic impact of factors related to the underlying disease and to the severity of acute organ failures might help avoiding futile admissions. We retrospectively assessed predictors of 30-day mortality in neutropenic (&lt;1000/ul) pts referred from a single Hematology unit to the 2 ICUs of the institution over a 10-year period. Of 66 consecutive pts, median age 48 (15–73), 82% had acute leukemia (AL) and 21% were in complete remission (CR). On ICU admission 62% of the pts had a neutrophil count ≤500/ul; microbiologically documented infection was found in 42%. The main reason for ICU referral was severe sepsis or septic shock in 62% of the cases and respiratory failure in 38%. Seventy per cent of the pts were already on vasopressor agents. At ICU entry the median Simplified Acute Physiology Score (SAPS) II was 63 and 26% of pts had ≥ 2 acute organ system failures (OSF). Coma was present in 23%. Mechanical ventilation was eventually needed in 89% and dialysis in 9% of the pts. Mortality at 30 days was 73%. By univariate logistic regression analysis mortality was not significantly related to age, to status of underlying disease (CR vs no CR/not yet known) to duration of neutropenia nor to depth of neutropenia at entry (≤ 500 vs &gt;500/ul). Pts who died were more likely to have non-M3 AL subtype vs M3 (p=0.037), to have ≥ 2 acute OSF vs &lt; 2 (p=0.012) and a higher SAPS II score (p&lt; 0.001). In multivariate analysis only the latter 2 variables remained significant. In conclusion, our data show that 27% of neutropenic pts admitted to ICUs are alive at 30 days; that selection for admission should not be based on the characteristics of the underlying malignancy; and that the 30-day mortality is highly predictable by initial acute illness severity scores.

scholarly journals Maternal admissions to Intensive Care Units in France: trends in rates, causes and severity

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Y Barry ◽  
C Deneux-Tharaux ◽  
M Saucedo ◽  
V Goulet ◽  
I Guseva-Canu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Temporal Trends ◽  
Simplified Acute Physiology Score ◽  
Incidence Rates ◽  
Icu Admission ◽  
Admission Rates ◽  
Saps Ii ◽  
Saps Ii Score ◽  
Territorial Disparities ◽  
Discharge Database

Abstract Introduction Maternal intensive care unit admission (ICU) is an indicator of severe maternal morbidity. This study aimed to estimate rates of maternal ICU admission during or following pregnancy in France, and to describe the characteristics of women admitted, the severity of their condition, associated diagnoses, regional disparities, and temporal trends between 2010 and 2014. Methods Women hospitalised in France in ICU during pregnancy or up to 42 days after pregnancy between 2010 and 2014 were identified using the national hospital discharge database (PMSI-MCO). The Simplified Acute Physiology Score (SAPS II) was used to estimate the severity. Trends in incidence rates were quantified using percentages of average annual variation based on a Poisson regression model. Results In total, 16,011 women were admitted to ICU, representing an overall rate of 3.97 ‰ deliveries. The average annual decrease in this rate between 2010 and 2014 was 1.7% (IC95%:-2, 00%; -1, 45%; p &lt; 0.0001) on average per year. The SAPS II score increased significantly from 18.4 in 2010 to 21.5 in 2014. Obstetrical hemorrhage (39.8%) and hypertensive complications during pregnancy (24.8%) were the most common reasons for admission. Within mainland France, we found notable disparities in maternal ICU admission rates between regions, from lowest in Pays-de-la-Loire region (2.69‰) to highest in Ile-de-France (5.05‰). Conclusions The rate of maternal ICU admission decreased from 2010 to 2014 in France, with a concomitant increase in case severity. Additional studies are needed to understand the territorial disparities identified in our study. Key messages The decreasing incidence of maternal ICU admission could be due to organisational changes with increased admission to intermediate care units. These changes have to be understood to accurately use maternal CU admission for maternal health surveillance.

A simplified acute physiology score in the prediction of acute organophosphate poisoning outcome in an intensive care unit

2007 ◽  
Vol 26 (8) ◽  
pp. 623-627 ◽  
Author(s):  
S. Shadnia ◽  
D. Darabi ◽  
A. Pajoumand ◽  
A. Salimi ◽  
M. Abdollahi
Keyword(s):  
Intensive Care ◽  
Simplified Acute Physiology Score ◽  
Acute Physiology Score ◽  
Organophosphate Poisoning ◽  
Poison Center ◽  
Survival Group ◽  
Icu Admission ◽  
Saps Ii ◽  
Saps Ii Score ◽  
The Impact

Organophosphate poisoning (OPP) occurs frequently and accounts for a large number of intoxication cases treated in intensive care units (ICU). Poisoning by these agents is a serious public health problem. Among pesticides, OPs are the main cause of poisoning and death in Loghman-Hakim Poison Center of Tehran, Iran. The aim of this study was to determine the impact of the Simplified Acute Physiology Score (SAPS II) in the prediction of mortality in patients with acute OPP requiring admission to the ICU of Loghman-Hakim Hospital Poison Center over a period of 12 months. This study was a prospective, case-control of records of patients with acute OPP admitted to the ICU between January 2006 and December 2006. The Demographic data were collected and SAPS II score was recorded. During the study period, 24 subjects were admitted to the ICU with acute OPP. All 24 patients (15 male) required endotracheal intubation and mechanical ventilation in addition to gastric decontamination and standard therapy with atropine and oximes and adequate hydration. Of these, 24 patients, eight (five male) died. SAPS II score was significantly higher in the non-survival group than the survival group. Mortality following acute OPP remains high despite adequate intensive care and specific therapy with atropine and oximes. One-third of the subjects needing intensive care die within the hospitalization period. SAPS II scores calculated within the first 24 hours were recognized as good prognostic indicator among patients with acute OPP that required ICU admission. It is concluded that SAPS II score above 11 within the first 24 hours is a predictor of poor outcome in patients with acute OPP requiring ICU admission. Human & Experimental Toxicology (2007) 26, 623—627

scholarly journals Comparison of risk prediction models in infarct-related cardiogenic shock

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Freund ◽  
J Poess ◽  
S De Waha-Thiele ◽  
R Meyer-Saraei ◽  
G Fuernau ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Risk Prediction ◽  
Prediction Models ◽  
Simplified Acute Physiology Score ◽  
Cardiovascular Research ◽  
Risk Prediction Models ◽  
Survival Probabilities ◽  
Saps Ii ◽  
Prognostic Assessment ◽  
Saps Ii Score

Abstract Background Several prediction models have been developed to allow accurate risk assessment and provide better treatment guidance in patients with infarct-related cardiogenic shock (CS). However, comparative data between these models are still scarce. Objectives To externally validate different risk prediction models in infarct-related CS and compare their predictive value in the early clinical course. Methods The Simplified Acute Physiology Score (SAPS)-II Score, the CardShock score, the IABP-SHOCK II score and the Society for Cardiovascular Angiography and Intervention (SCAI) classification were each externally validated in a total of 1055 patients with infarct-related CS enrolled into the randomized CULPRIT-SHOCK trial or the corresponding registry. Discriminative power was assessed by comparing area under the curves (AUC) in case of continuous scores. Results In direct comparison of the continuous scores in a total of 161 patients, the IABP-SHOCK II score revealed best discrimination (AUC=0.74), followed by the CardShock score (AUC=0.69) and the SAPS-II score, giving only moderate discrimination (AUC=0.63). All of the three scores revealed acceptable calibration by Hosmer-Lemeshow test. The SCAI classification as a categorical predictive model displayed good prognostic assessment for the highest risk group (stage E), but showed poor discrimination between stages C and D with respect to short-term-mortality. Conclusion Based on the present findings, the IABP-SHOCK II score appears to be the most suitable of the examined models for immediate risk prediction in infarct-related CS. Prospective evaluation of the models, further modification or even development of new scores might be necessary to reach higher levels of discrimination. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Union, German Centre for Cardiovascular Research Survival probabilities continuous scores Survival probabilities SCAI

scholarly journals Sentiment Analysis for Necessary Preview of 30-Day Mortality in Sepsis Patients and the Control Strategies

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yanqun Zou ◽  
Jian Wang ◽  
Zheng Lei ◽  
Yuanjun Zhang ◽  
Wenfeng Wang
Keyword(s):  
Intensive Care ◽  
Sentiment Analysis ◽  
Medical Information ◽  
Cox Regression ◽  
Control Strategies ◽  
Area Under The Curve ◽  
Prognostic Index ◽  
Simplified Acute Physiology Score ◽  
Prediction Ability ◽  
Cox Analysis

This study was to preview the risk of 30-day mortality in sepsis patients using sentiment analysis. The clinical data of patients and nursing notes were collected from the Medical Information Mart for Intensive Care (MIMIC-III) database. The factors influencing 30-day mortality were analyzed using the Cox regression model. And, the prognostic index (PI) was estimated. The receiver operating characteristic (ROC) curve was used to determine the PI cut-off point and assess the prediction ability of the model. In total, 1844 of 3560 patients were eligible for the study, with a 30-day mortality of 37.58%. Multivariate Cox analysis showed that sentiment polarity scores, sentiment subjectivity scores, simplified acute physiology score (SAPS)-II, age, and intensive care unit (ICU) types were all associated with the risk of 30-day mortality ( P < 0.05 ). In the preview of 30-day mortality, the area under the curve (AUC) of ROC was 0.78 (95%CI: 0.74–0.81, P < 0.001 ) when the cut-off point of PI was 0.467. The documented notes from nurses were described for the first time. Sentiment scores measured in nursing notes are associated with the risk of 30-day mortality in sepsis patients and may improve the preview of 30-day mortality.

Prolonged Elevated Heart Rate and 90-Day Survival in Acutely Ill Patients: Data From the MIMIC-III Database

2018 ◽  
Vol 34 (8) ◽  
pp. 622-629 ◽  
Author(s):  
Veit Sandfort ◽  
Alistair E.W. Johnson ◽  
Lauren M. Kunz ◽  
Jose D. Vargas ◽  
Douglas R. Rosing
Keyword(s):  
Heart Rate ◽  
Logistic Regression ◽  
Intensive Care ◽  
Risk Of Death ◽  
Saps Ii ◽  
Increased Risk ◽  
Saps Ii Score ◽  
The Mean ◽  
Mimic Iii ◽  
Elevated Heart Rate

Purpose: We sought to evaluate the association of prolonged elevated heart rate (peHR) with survival in acutely ill patients. Methods: We used a large observational intensive care unit (ICU) database (Multiparameter Intelligent Monitoring in Intensive Care III [MIMIC-III]), where frequent heart rate measurements were available. The peHR was defined as a heart rate >100 beats/min in 11 of 12 consecutive hours. The outcome was survival status at 90 days. We collected heart rates, disease severity (simplified acute physiology scores [SAPS II]), comorbidities (Charlson scores), and International Classification of Diseases (ICD) diagnosis information in 31 513 patients from the MIMIC-III ICU database. Propensity score (PS) methods followed by inverse probability weighting based on the PS was used to balance the 2 groups (the presence/absence of peHR). Multivariable weighted logistic regression was used to assess for association of peHR with the outcome survival at 90 days adjusting for additional covariates. Results: The mean age was 64 years, and the most frequent main disease category was circulatory disease (41%). The mean SAPS II score was 35, and the mean Charlson comorbidity score was 2.3. Overall survival of the cohort at 90 days was 82%. Adjusted logistic regression showed a significantly increased risk of death within 90 days in patients with an episode of peHR ( P < .001; odds ratio for death 1.79; confidence interval, 1.69-1.88). This finding was independent of median heart rate. Conclusion: We found a significant association of peHR with decreased survival in a large and heterogenous cohort of ICU patients.

scholarly journals A heart failure phenotype stratified model for predicting 1-year mortality in patients admitted with acute heart failure: results from an individual participant data meta-analysis of four prospective European cohorts

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuntao Chen ◽  
Adriaan A. Voors ◽  
Tiny Jaarsma ◽  
Chim C. Lang ◽  
Iziah E. Sama ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Decision Making ◽  
Cox Model ◽  
Meta Analysis ◽  
Prognostic Index ◽  
Individual Participant Data ◽  
Mortality Risks ◽  
Baseline Mortality ◽  
Individual Participant ◽  
Stratified Model

Abstract Background Prognostic models developed in general cohorts with a mixture of heart failure (HF) phenotypes, though more widely applicable, are also likely to yield larger prediction errors in settings where the HF phenotypes have substantially different baseline mortality rates or different predictor-outcome associations. This study sought to use individual participant data meta-analysis to develop an HF phenotype stratified model for predicting 1-year mortality in patients admitted with acute HF. Methods Four prospective European cohorts were used to develop an HF phenotype stratified model. Cox model with two rounds of backward elimination was used to derive the prognostic index. Weibull model was used to obtain the baseline hazard functions. The internal-external cross-validation (IECV) approach was used to evaluate the generalizability of the developed model in terms of discrimination and calibration. Results 3577 acute HF patients were included, of which 2368 were classified as having HF with reduced ejection fraction (EF) (HFrEF; EF < 40%), 588 as having HF with midrange EF (HFmrEF; EF 40–49%), and 621 as having HF with preserved EF (HFpEF; EF ≥ 50%). A total of 11 readily available variables built up the prognostic index. For four of these predictor variables, namely systolic blood pressure, serum creatinine, myocardial infarction, and diabetes, the effect differed across the three HF phenotypes. With a weighted IECV-adjusted AUC of 0.79 (0.74–0.83) for HFrEF, 0.74 (0.70–0.79) for HFmrEF, and 0.74 (0.71–0.77) for HFpEF, the model showed excellent discrimination. Moreover, there was a good agreement between the average observed and predicted 1-year mortality risks, especially after recalibration of the baseline mortality risks. Conclusions Our HF phenotype stratified model showed excellent generalizability across four European cohorts and may provide a useful tool in HF phenotype-specific clinical decision-making.

scholarly journals Outcomes of severe systemic rheumatic disease patients requiring extracorporeal membrane oxygenation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pierre Bay ◽  
Guillaume Lebreton ◽  
Alexis Mathian ◽  
Pierre Demondion ◽  
Cyrielle Desnos ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Left Ventricular ◽  
Arterial Lactate ◽  
Saps Ii ◽  
Membrane Oxygenation ◽  
Saps Ii Score ◽  
Va Ecmo ◽  
Vv Ecmo

Abstract Background Systemic rheumatic diseases (SRDs) are a group of inflammatory disorders that can require intensive care unit (ICU) admission because of multiorgan involvement with end-organ failure(s). Critically ill SRD patients requiring extracorporeal membrane oxygenation (ECMO) were studied to gain insight into their characteristics and outcomes. Methods This French monocenter, retrospective study included all SRD patients requiring venovenous (VV)- or venoarterial (VA)-ECMO admitted to a 26-bed ECMO-dedicated ICU from January 2006 to February 2020. The primary endpoint was in-hospital mortality. Results Ninety patients (male/female ratio: 0.5; mean age at admission: 41.6 ± 15.2 years) admitted to the ICU received VA/VV-ECMO, respectively, for an SRD-related flare (n = 69, n = 38/31) or infection (n = 21, n = 10/11). SRD was diagnosed in-ICU for 31 (34.4%) patients. In-ICU and in-hospital mortality rates were 48.9 and 51.1%, respectively. Nine patients were bridged to cardiac (n = 5) or lung transplantation (n = 4), or left ventricular assist device (n = 2). The Cox multivariable model retained the following independent predictors of in-hospital mortality: in-ICU SRD diagnosis, day-0 Simplified Acute Physiology Score (SAPS) II score ≥ 70 and arterial lactate ≥ 7.5 mmol/L for VA-ECMO–treated patients; diagnosis other than vasculitis, day-0 SAPS II score ≥ 70, ventilator-associated pneumonia and arterial lactate ≥ 7.5 mmol/L for VV-ECMO–treated patients. Conclusions ECMO support is a relevant rescue technique for critically ill SRD patients, with 49% survival at hospital discharge. Vasculitis was independently associated with favorable outcomes of VV-ECMO–treated patients. Further studies are needed to specify the role of ECMO for SRD patients.

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