Representation learning in intraoperative vital signs for heart failure risk prediction.

backgroundThe probability of heart failure during the perioperative period is 2% on average and it is as high as 17% when accompanied by cardiovascular diseases in China. It has been the most significant cause of postoperative death of patients. However, the patient is managed by the flow of information during the operation, but a lot of clinical information can make it difficult for medical staff to identify the information relevant to patient care. There are major practical and technical barriers to understand perioperative complications.

methodsIn this work, we present three machine learning methods to estimate risks of heart failure, which extract intraoperative vital signs monitoring data into different modal representations (statistical learning representation, text learning representation, image learning representation). Firstly, we extracted features of vital signs monitoring data of surgical patients by statistical analysis. Secondly, the vital signs data is converted into text information by Piecewise Approximate Aggregation (PAA) and Symbolic Aggregate Approximation (SAX), then Latent Dirichlet Allocation (LDA) model is used to extract text topics of patients for heart failure prediction. Thirdly, the vital sign monitoring time series data of the surgical patient is converted into a grid image by using the grid representation, and then the convolutional neural network is directly used to identify the grid image for heart failure prediction. We evaluated the proposed methods in the monitoring data of real patients during the perioperative period.

resultsIn this paper, the results of our experiment demonstrate the Gradient Boosting Decision Tree (GBDT) classifier achieves the best results in the prediction of heart failure by statistical feature representation. The sensitivity, specificity and the area under the curve (AUC) of the best method can reach 83, 85 and 84% respectively.

conclusionsThe experimental results demonstrate that representation learning model of vital signs monitoring data of intraoperative patients can effectively capture the physiological characteristics of postoperative heart failure.