Combining Predictive Models of Mortality and Time-to-Discharge for Improved Outcome Assessment in Intensive Care Units

Identifier:  imarina:9462623

Handle: https://hdl.handle.net/20.500.11797/imarina9462623

Authors:  Pardo, Alex; Gomez, Josep; Berrueta, Julen; Garcia, Alejandro; Manrique, Sara; Rodriguez, Alejandro; Bodi, Maria

Abstract:
Background: The Patient Outcome Assessment and Decision Support (PADS) model is a real-time framework designed to predict both mortality and the likelihood of discharge within 48 h in critically ill patients. By combining these predictions, PADS enables clinically meaningful stratification of patient trajectories, supporting bedside decision-making and the planning of critical care resources such as nursing allocation and surgical scheduling. Methods: PADS integrates routinely collected clinical data: SOFA variables, age, gender, admission type, and comorbidities. It consists of two Long Short-Term Memory (LSTM) neural networks-one predicting the probability of death and the other the probability of discharge within 48 h. The combination places each patient into one of four states: alive/discharged within 48 h, alive/not discharged, dead within 48 h, or dead later. The model was trained using MIMIC-IV data, emphasizing ease of implementation in units with electronic health records. Out of the 76,540 stays present in MIMIC-IV (53,150 patients), 32,875 (25,555 patients) were used after excluding those with short stays (