Multi-stage model for predicting probabilities of mortality in adult critically ill patients
First Claim
1. One or more non-transitory computer-storage media having computer-executable instructions embodied thereon for performing a method in a clinical computing environment for predicting a probability of mortality for a patient admitted to an Intensive Care Unit, the method comprising:
- determining a length of a first Intensive-Care-Unit-day for the patient;
calculating a first mortality probability utilizing a first mortality prediction model, the first mortality prediction model being based on physiological data items collected within the patient'"'"'s first Intensive-Care-Unit-day;
calculating a second mortality probability utilizing a second mortality prediction model, the second mortality prediction model being based on clinical data items collected within one hour of the patient being admitted to the Intensive Care Unit;
determining a difference between the second mortality probability and the first mortality probability;
calculating the probability of mortality for the patient utilizing Equation 1;
eYi/(1+eYi),wherein Yi is calculated utilizing Equation 2;
Yi=β
0+(β
1)(A)+(β
2)(λ
)+(β
3)(δ
(MA)),wherein Yi equals zero if the patient survives and one if the patient dies, wherein A equals the logit of the first mortality probability, wherein λ
equals the length of the first Intensive-Care-Unit-day, wherein δ
(MA) equals one if the difference between the second mortality probability and the first mortality probability exceeds 0.15 and zero if the difference between the second mortality probability and the first mortality probability is less than or equal to 0.15, and wherein values for β
0, β
1, β
2, and β
3 are obtained through a logistic regression procedure using Equation 2; and
assessing ICU performance by comparing observed and predicted mortality.
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Abstract
Computerized methods in a clinical computing environment for predicting mortality in critically ill patients, that is, patients admitted to Intensive Care Units, are provided. In accordance with embodiments hereof, at least two distinctly different mortality prediction models (e.g., the Acute Physiology and Chronic Health Evaluation (APACHE®) model and the Mortality Probability Model at Admission (MPM0) are utilized in a multi-stage fashion to determine, with better accuracy than may be provided by either mortality prediction model alone, the probability of mortality for critically ill adult patients.
16 Citations
13 Claims
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1. One or more non-transitory computer-storage media having computer-executable instructions embodied thereon for performing a method in a clinical computing environment for predicting a probability of mortality for a patient admitted to an Intensive Care Unit, the method comprising:
-
determining a length of a first Intensive-Care-Unit-day for the patient; calculating a first mortality probability utilizing a first mortality prediction model, the first mortality prediction model being based on physiological data items collected within the patient'"'"'s first Intensive-Care-Unit-day; calculating a second mortality probability utilizing a second mortality prediction model, the second mortality prediction model being based on clinical data items collected within one hour of the patient being admitted to the Intensive Care Unit; determining a difference between the second mortality probability and the first mortality probability; calculating the probability of mortality for the patient utilizing Equation 1;
eYi/(1+eYi),wherein Yi is calculated utilizing Equation 2;
Yi=β
0+(β
1)(A)+(β
2)(λ
)+(β
3)(δ
(MA)),wherein Yi equals zero if the patient survives and one if the patient dies, wherein A equals the logit of the first mortality probability, wherein λ
equals the length of the first Intensive-Care-Unit-day, wherein δ
(MA) equals one if the difference between the second mortality probability and the first mortality probability exceeds 0.15 and zero if the difference between the second mortality probability and the first mortality probability is less than or equal to 0.15, and wherein values for β
0, β
1, β
2, and β
3 are obtained through a logistic regression procedure using Equation 2; andassessing ICU performance by comparing observed and predicted mortality. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A method in a clinical computing environment for predicting a probability of mortality for a patient admitted to an Intensive Care Unit, the method comprising:
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determining a length of a first Intensive-Care-Unit-day for the patient; calculating, via a first computing process, a first mortality probability utilizing the Acute Physiology and Chronic Health Evaluation mortality prediction model; calculating, via a second computing process, a second mortality probability utilizing the Mortality Probability Model at Admission mortality prediction model; determining a difference between the second mortality probability and the first mortality probability; calculating, via a third computing process, the probability of mortality for the patient utilizing Equation 1;
eYi/(1+eYi),wherein Yi is calculated via a fourth computing process utilizing Equation 2;
Yi=β
0+(β
1)(A)+(β
2)(λ
)+(β
3)(δ
(MA)),wherein Yi equals zero if the patient survives and one if the patient dies, wherein A equals the logit of the first mortality probability, wherein λ
equals the length of the first Intensive-Care-Unit-day, wherein δ
(MA) equals one if the difference between the second mortality probability and the first mortality probability exceeds 0.15 and zero if the difference between the second mortality probability and the first mortality probability is less than or equal to 0.15, and wherein values for β
0, β
1, β
2, and β
3 are obtained through a logistic regression procedure using Equation 2,and wherein the first, second, third, and fourth computing process are performed utilizing one or more computing devices; and assessing ICU performance by comparing observed and predicted mortality. - View Dependent Claims (10, 11, 12, 13)
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Specification