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Journal Article Multilayer Perceptron-Based Real-Time Intradialytic Hypotension Prediction Using Patient Baseline Information and Heart-Rate Variation
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Authors
Tae Wuk Bae, Min Seong Kim, Jong Won Park, Kee Koo Kwon, Kyu Hyung Kim
Issue Date
2022-08
Citation
International Journal of Environmental Research and Public Health, v.19, no.16, pp.1-22
ISSN
1661-7827
Publisher
MDPI
Language
English
Type
Journal Article
DOI
https://dx.doi.org/10.3390/ijerph191610373
Abstract
Intradialytic hypotension (IDH) is a common side effect that occurs during hemodialysis and poses a great risk for dialysis patients. Many studies have been conducted so far to predict IDH, but most of these could not be applied in real-time because they used only underlying patient information or static patient disease information. In this study, we propose a multilayer perceptron (MP)-based IDH prediction model using heart rate (HR) information corresponding to time-series information and static data of patients. This study aimed to validate whether HR differences and HR slope information affect real-time IDH prediction in patients undergoing hemodialysis. Clinical data were collected from 80 hemodialysis patients from 9 September to 17 October 2020, in the artificial kidney room at Yeungnam University Medical Center (YUMC), Daegu, South Korea. The patients typically underwent hemodialysis 12 times during this period, 1 to 2 h per session. Therefore, the HR difference and HR slope information within up to 1 h before IDH occurrence were used as time-series input data for the MP model. Among the MP models using the number and data length of different hidden layers, the model using 60 min of data before the occurrence of two layers and IDH showed maximum performance, with an accuracy of 81.5%, a true positive rate of 73.8%, and positive predictive value of 87.3%. This study aimed to predict IDH in real-time by continuously supplying HR information to MP models along with static data such as age, diabetes, hypertension, and ultrafiltration. The current MP model was implemented using relatively limited parameters; however, its performance may be further improved by adding additional parameters in the future, further enabling real-time IDH prediction to play a supporting role for medical staff.
KSP Keywords
1 H, 2 H, Additional parameters, Artificial kidney, Clinical data, Data length, Different hidden layers, Hemodialysis patients, Hypotension prediction, Patient information, Positive predictive value(PPV)
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