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Proceedings of the Annual Symposium on Computer Application in Medical Care logoLink to Proceedings of the Annual Symposium on Computer Application in Medical Care
. 1992:666–672.

Use of a neural network as a predictive instrument for length of stay in the intensive care unit following cardiac surgery.

J V Tu 1, M R Guerriere 1
PMCID: PMC2248140  PMID: 1482955

Abstract

A patient's intensive care unit (ICU) length of stay following cardiac surgery is an important issue in Canada, where cardiovascular intensive care resources are limited and waiting lists for cardiac surgery exist. A predictive instrument for ICU length of stay could lead to improved utilization of existing ICU and operating room resources through better scheduling of patients and staff. We trained a neural network with a database of 713 patients and 15 input variables to predict patients who would have a prolonged ICU length of stay, which we defined as a stay greater than 2 days. In an independent test set of 696 patients, the network was able to stratify patients into three risk groups for prolonged stay (low, intermediate, and high), corresponding to frequencies of prolonged stay of 16.3%, 35.3%, and 60.8% respectively. The performance of the network was also evaluated by calculating the area under the Receiver Operating Characteristic (ROC) curve in the training set, 0.7094 (SE 0.0224), and in the test set, 0.6960 (SE 0.0227). We believe the trained network would be a useful predictive instrument for optimizing the scheduling of cardiac surgery patients in times of limited ICU resources. Neural networks are a new alternative method for developing predictive instruments that offer both advantages and disadvantages when compared to other more widely used statistical techniques.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baxt W. G. Use of an artificial neural network for the diagnosis of myocardial infarction. Ann Intern Med. 1991 Dec 1;115(11):843–848. doi: 10.7326/0003-4819-115-11-843. [DOI] [PubMed] [Google Scholar]
  2. Gilpin E. A., Olshen R. A., Chatterjee K., Kjekshus J., Moss A. J., Henning H., Engler R., Blacky A. R., Dittrich H., Ross J., Jr Predicting 1-year outcome following acute myocardial infarction: physicians versus computers. Comput Biomed Res. 1990 Feb;23(1):46–63. doi: 10.1016/0010-4809(90)90006-x. [DOI] [PubMed] [Google Scholar]
  3. Gross G. W., Boone J. M., Greco-Hunt V., Greenberg B. Neural networks in radiologic diagnosis. II. Interpretation of neonatal chest radiographs. Invest Radiol. 1990 Sep;25(9):1017–1023. doi: 10.1097/00004424-199009000-00013. [DOI] [PubMed] [Google Scholar]
  4. Guerriere M. R., Detsky A. S. Neural networks: what are they? Ann Intern Med. 1991 Dec 1;115(11):906–907. doi: 10.7326/0003-4819-115-11-906. [DOI] [PubMed] [Google Scholar]
  5. Gustafson D. H., Fryback D. G., Rose J. H., Yick V., Prokop C. T., Detmer D. E., Moore J. A decision theoretic methodology for severity index development. Med Decis Making. 1986 Jan-Mar;6(1):27–35. doi: 10.1177/0272989X8600600106. [DOI] [PubMed] [Google Scholar]
  6. Katz N. M., Ahmed S. W., Clark B. K., Wallace R. B. Predictors of length of hospitalization after cardiac surgery. Ann Thorac Surg. 1988 Jun;45(6):656–660. doi: 10.1016/s0003-4975(10)64770-4. [DOI] [PubMed] [Google Scholar]
  7. Lazar H. L., Wilcox K., McCormick J. R., Roberts A. J. Determinants of discharge following coronary artery bypass graft surgery. Chest. 1987 Nov;92(5):800–803. doi: 10.1378/chest.92.5.800. [DOI] [PubMed] [Google Scholar]
  8. Naylor C. D. A different view of queues in Ontario. Health Aff (Millwood) 1991 Fall;10(3):110–128. doi: 10.1377/hlthaff.10.3.110. [DOI] [PubMed] [Google Scholar]
  9. O'Connor G. T., Plume S. K., Olmstead E. M., Coffin L. H., Morton J. R., Maloney C. T., Nowicki E. R., Tryzelaar J. F., Hernandez F., Adrian L. A regional prospective study of in-hospital mortality associated with coronary artery bypass grafting. The Northern New England Cardiovascular Disease Study Group. JAMA. 1991 Aug 14;266(6):803–809. [PubMed] [Google Scholar]
  10. Wasson J. H., Sox H. C., Neff R. K., Goldman L. Clinical prediction rules. Applications and methodological standards. N Engl J Med. 1985 Sep 26;313(13):793–799. doi: 10.1056/NEJM198509263131306. [DOI] [PubMed] [Google Scholar]
  11. Weintraub W. S., Jones E. L., Craver J., Guyton R., Cohen C. Determinants of prolonged length of hospital stay after coronary bypass surgery. Circulation. 1989 Aug;80(2):276–284. doi: 10.1161/01.cir.80.2.276. [DOI] [PubMed] [Google Scholar]

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