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research article

Forecasting intracranial hypertension using multi-scale waveform metrics

Hueser, Matthias
•
Kuendig, Adrian
•
Karlen, Walter
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January 1, 2020
Physiological Measurement

Objective: Acute intracranial hypertension is an important risk factor of secondary brain damage after traumatic brain injury. Hypertensive episodes are often diagnosed reactively, leading to late detection and lost time for intervention planning. A pro-active approach that predicts critical events several hours ahead of time could assist in directing attention to patients at risk. Approach: We developed a prediction framework that forecasts onsets of acute intracranial hypertension in the next 8 h. It jointly uses cerebral auto-regulation indices, spectral energies and morphological pulse metrics to describe the neurological state of the patient. One-minute base windows were compressed by computing signal metrics, and then stored in a multi-scale history, from which physiological features were derived. Main results: Our model predicted events up to 8 h in advance with an alarm recall rate of 90% at a precision of 30% in the MIMIC-III waveform database, improving upon two baselines from the literature. We found that features derived from high-frequency waveforms substantially improved the prediction performance over simple statistical summaries of low-frequency time series, and each of the three feature classes contributed to the performance gain. The inclusion of long-term history up to 8 h was especially important. Significance: Our results highlight the importance of information contained in high-frequency waveforms in the neurological intensive care unit. They could motivate future studies on pre-hypertensive patterns and the design of new alarm algorithms for critical events in the injured brain.

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Type
research article
DOI
10.1088/1361-6579/ab6360
Web of Science ID

WOS:000514636300001

Author(s)
Hueser, Matthias
Kuendig, Adrian
Karlen, Walter
De Luca, Valeria
Jaggi, Martin  
Date Issued

2020-01-01

Publisher

IOP PUBLISHING LTD

Published in
Physiological Measurement
Volume

41

Issue

1

Article Number

014001

Subjects

Biophysics

•

Engineering, Biomedical

•

Physiology

•

Engineering

•

cerebral auto-regulation indices

•

intracranial hypertension

•

intracranial pressure

•

machine learning

•

icp pulse morphology

•

traumatic brain-injury

•

intensive-care-unit

•

cerebral perfusion-pressure

•

secondary insults

•

serum biomarkers

•

reactivity

•

management

•

outcomes

•

pathophysiology

•

autoregulation

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
MLO  
Available on Infoscience
March 6, 2020
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/167068
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