Forecasting intracranial hypertension using multi-scale waveform metrics

02/25/2019
by   Matthias Hüser, et al.
0

Objective: Intracranial hypertension is an important risk factor of secondary brain damage after traumatic brain injury. Hypertensive episodes are often diagnosed reactively and time is lost before counteractive measures are taken. A pro-active approach that predicts critical events ahead of time could be beneficial for the patient. Methods: We developed a prediction framework that forecasts onsets of intracranial hypertension in the next 8 hours. Its main innovation is the joint use of cerebral auto-regulation indices, spectral energies and morphological pulse metrics to describe the neurological state. One-minute base windows were compressed by computing signal metrics, and then stored in a multi-scale history, from which physiological features were derived. Results: Our model predicted intracranial hypertension up to 8 hours in advance with alarm recall rates of 90 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, in which each of the three feature categories contributed to the performance gain. The inclusion of long-term history up to 8 hours was especially important. Conclusion: Our approach showed promising performance and enabled us to gain insights about the critical components of prediction models for intracranial hypertension. 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.

READ FULL TEXT

Please sign up or login with your details

Forgot password? Click here to reset