IN-HOSPITAL MORTALITY PREDICTION IN PATIENTS RECEIVING MECHANICAL VENTILATION IN TAIWAN.

Background: Few studies have used pooled data for more than 2 years and few have analyzed data for patients receiving mechanical ventilation in Taiwan. Objective: To validate the use of an artificial neural network model for predicting in-hospital mortality in patients receiving mechanical ventilati...

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Publicado en:American Journal of Critical Care Vol. 22; no. 6; pp. 506 - 514
Autores principales: Chao-Ju Chen, Hon-Yi Shi, King-Teh Lee, Tzuu-Yuan Huang
Formato: research tables/charts Journal Article
Publicado: American Association of Critical-Care Nurses Nov2013
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2013
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      pub: American Association of Critical-Care Nurses
      place: Alisa Veijo, California
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        atl: IN-HOSPITAL MORTALITY PREDICTION IN PATIENTS RECEIVING MECHANICAL VENTILATION IN TAIWAN.
      aug:
        au:
          Chao-Ju Chen
          Hon-Yi Shi
          King-Teh Lee
          Tzuu-Yuan Huang
        affil: Head, Department of Respiratory Therapy, Madou Sin-Lau Hospital, Tainan, Taiwan
      sug:
        subj:
          Respiration, Artificial Taiwan
          Hospital Mortality Taiwan
          Ventilator Patients
          Taiwan
          Neural Networks (Computer)
          Logistic Regression
          Human
          ROC Curve
          T-Tests
          Validation Studies
          Record Review
          Databases
          International Classification of Diseases
          Length of Stay
          Scales
          One-Way Analysis of Variance
          Age Factors
          Sex Factors
          Fisher's Exact Test
          Sensitivity and Specificity
          Chi Square Test
          Male
          Female
          Middle Age
          Aged
          Aged, 80 and Over
          Predictive Research
          Odds Ratio
          Confidence Intervals
          Hospitals Classification
          Predictive Value of Tests
          Effect Size
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background: Few studies have used pooled data for more than 2 years and few have analyzed data for patients receiving mechanical ventilation in Taiwan. Objective: To validate the use of an artificial neural network model for predicting in-hospital mortality in patients receiving mechanical ventilation in Taiwan and to compare the predictive accuracy of the artificial neural network model with that of a logistic regression model. Methods: Retrospective comparison of 1000 pairs of data sets processed by logistic regression and artificial neural network models based on initial clinical data for 213 945 patients receiving mechanical ventilation. For each pair of artificial neural network and logistic regression models, the area under the receiver operating characteristic curves, Hosmer-Lemeshow statistics, and accuracy rate were calculated and compared by using t tests. Global sensitivity analysis and sensitivity score approach were also used to assess the relative significance of input parameters in the system model and the relative importance of variables. Results: Compared with the logistic regression model, the artificial neural network model had a better accuracy rate in 96.3% of cases, better Hosmer-Lemeshow statistics in 41.2% of cases, and a better area under the curve in 97.6% of cases. Hospital volume was the most influential (sensitive) variable affecting in-hospital mortality, followed by Charlson comorbidity index, length of stay, and hospital type. Conclusions: Compared with the conventional logistic regression model, the artificial neural network model was more accurate in predicting in-hospital mortality and had higher overall performance indices.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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