Predi\c{c}\~ao de Incid\^encia de Les\~ao por Press\~ao em Pacientes de UTI usando Aprendizado de M\'aquina

TL;DR

This study demonstrates that machine learning models using electronic health records can predict pressure ulcer risk in ICU patients more accurately than the traditional Braden scale, with improved evaluation and training methods.

Contribution

Introduces a novel evaluation approach considering all predictions during a stay and a new training method for machine learning models in pressure ulcer prediction.

Findings

Models outperform the state of the art in pressure ulcer prediction.

All models surpass the Braden scale in precision-recall performance.

Proposed methods improve early detection of pressure ulcers in ICU patients.

Abstract

Pressure ulcers have high prevalence in ICU patients but are preventable if identified in initial stages. In practice, the Braden scale is used to classify high-risk patients. This paper investigates the use of machine learning in electronic health records data for this task, by using data available in MIMIC-III v1.4. Two main contributions are made: a new approach for evaluating models that considers all predictions made during a stay, and a new training method for the machine learning models. The results show a superior performance in comparison to the state of the art; moreover, all models surpass the Braden scale in every operating point in the precision-recall curve. -- -- Les\~oes por press\~ao possuem alta preval\^encia em pacientes de UTI e s\~ao preven\'iveis ao serem identificadas em est\'agios iniciais. Na pr\'atica utiliza-se a escala de Braden para classifica\c{c}\~ao de pacientes em risco. Este artigo investiga o uso de aprendizado de m\'aquina em dados de registros eletr\^onicos para este fim, a partir da base de dados MIMIC-III v1.4. S\~ao feitas duas contribui\c{c}\~oes principais: uma nova abordagem para a avalia\c{c}\~ao dos modelos e da escala de Braden levando em conta todas as predi\c{c}\~oes feitas ao longo das interna\c{c}\~oes, e um novo m\'etodo de treinamento para os modelos de aprendizado de m\'aquina. Os resultados obtidos superam o estado da arte e verifica-se que os modelos superam significativamente a escala de Braden em todos os pontos de opera\c{c}\~ao da curva de precis\~ao por sensibilidade.