Predição de sepse em unidade de terapia intensiva: uma abordagem de aprendizado de máquina
Resumo
A sepse e uma disfunção orgânica com risco de vida e uma das principais causas de mortalidade em Unidade de Terapia Intensiva (UTI). O diagnóstico precoce da sepse é fundamental, considerando que a pronta intervenção médica melhora o desfecho do paciente. O início do protocolo de tratamento de sepse no tempo certo reduz a mortalidade. Nosso objetivo é prever a sepse seis horas antes do desenvolvimento dos sintomas que levariam a um diagnóstico clínico de acordo com as diretrizes da Sepsis-3.
Referências
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Bone, R. C., Balk, R. A., Cerra, F. B., Dellinger, R. P., Fein, A. M., Knaus, W. A., Schein, R. M., and Sibbald, W. J. (1992). Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest, 101(6):1644–1655.
Dias, F. S., Rezende, E. A. d. C., Mendes, C. L., Silva Jr, J. M., and Sanches, J. L. (2014). Hemodynamic monitoring in the intensive care unit: a Brazilian perspective. Revista Brasileira de terapia intensiva, 26(4):360–366.
ILAS (2018). Morte por infecção e duas vezes maior na rede pública do que na privada. https://ilas.org.br/interacao/?p=357. Accessed: 2020-03-07.
James, G., Witten, D., Hastie, T., and Tibshirani, R. (2013). An Introduction to Statistical Learning: with Applications in R. Springer Texts in Statistics. Springer New York.
Johnson, A. E., Pollard, T. J., Shen, L., Li-wei, H. L., Feng, M., Ghassemi, M., Moody, B., Szolovits, P., Celi, L. A., and Mark, R. G. (2016). MIMIC-III, a freely accessible critical care database. Scientific data, 3:160035.
Knaus, W. A., Draper, E. A., Wagner, D. P., and Zimmerman, J. E. (1985). APACHE II: a severity of disease classification system. Critical care medicine, 13(10):818–829.
Kumar, A., Roberts, D., Wood, K. E., Light, B., Parrillo, J. E., Sharma, S., Suppes, R., Feinstein, D., Zanotti, S., Taiberg, L., et al. (2006). Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Critical care medicine, 34(6):1589–1596.
Le, S., Hoffman, J., Barton, C., Fitzgerald, J. C., Allen, A., Pellegrini, E., Calvert, J., and Das, R. (2019). Pediatric severe sepsis prediction using machine learning. Frontiers in Pediatrics, 7:413.
Levy, M. M., Evans, L. E., and Rhodes, A. (2018). The Surviving Sepsis Campaign Bundle: 2018 Update. Intensive care medicine, 44(6):925–928.
Machado, F. R., Cavalcanti, A. B., Bozza, F. A., Ferreira, E. M., Carrara, F. S. A., Sousa, J. L., Caixeta, N., Salomao, R., Angus, D. C., Azevedo, L. C. P., et al. (2017). The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study. The Lancet Infectious Diseases, 17(11):1180–1189.
Reyna, M., Josef, C., Jeter, R., Shashikumar, S., Westover, M., Nemati, S., Clifford, G., and Sharma, A. (2019). Early prediction of sepsis from clinical data: the PhysioNet/Computing in Cardiology Challenge 2019. Critical Care Medicine.
Royal College of Physicians (2017). National Early Warning Score (NEWS) 2: Standardising the assessment of acute-illness severity in the NHS.
Seymour, C. W., Gesten, F., Prescott, H. C., Friedrich, M. E., Iwashyna, T. J., Phillips, G. S., Lemeshow, S., Osborn, T., Terry, K. M., and Levy, M. M. (2017). Time to treatment and mortality during mandated emergency care for sepsis. New England Journal of Medicine, 376(23):2235–2244.
Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., Bellomo, R., Bernard, G. R., Chiche, J.-D., Coopersmith, C. M., et al. (2016). The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA: The Journal of the American Medical Association, 315(8):801–810.
Vincent, J.-L., Moreno, R., Takala, J., Willatts, S., De Mendonça, A., Bruining, H., Reinhart, C., Suter, P., and Thijs, L. (1996). The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive care medicine, 22(7):707–710.
Bayer, O., Schwarzkopf, D., Stumme, C., Stacke, A., Hartog, C. S., Hohenstein, C., Kabisch, B., Reichel, J., Reinhart, K., and Winning, J. (2015). An early warning scoring system to identify septic patients in the prehospital setting: the PRESEP score. Academic emergency medicine, 22(7):868–871.
Bone, R. C., Balk, R. A., Cerra, F. B., Dellinger, R. P., Fein, A. M., Knaus, W. A., Schein, R. M., and Sibbald, W. J. (1992). Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest, 101(6):1644–1655.
Dias, F. S., Rezende, E. A. d. C., Mendes, C. L., Silva Jr, J. M., and Sanches, J. L. (2014). Hemodynamic monitoring in the intensive care unit: a Brazilian perspective. Revista Brasileira de terapia intensiva, 26(4):360–366.
ILAS (2018). Morte por infecção e duas vezes maior na rede pública do que na privada. https://ilas.org.br/interacao/?p=357. Accessed: 2020-03-07.
James, G., Witten, D., Hastie, T., and Tibshirani, R. (2013). An Introduction to Statistical Learning: with Applications in R. Springer Texts in Statistics. Springer New York.
Johnson, A. E., Pollard, T. J., Shen, L., Li-wei, H. L., Feng, M., Ghassemi, M., Moody, B., Szolovits, P., Celi, L. A., and Mark, R. G. (2016). MIMIC-III, a freely accessible critical care database. Scientific data, 3:160035.
Knaus, W. A., Draper, E. A., Wagner, D. P., and Zimmerman, J. E. (1985). APACHE II: a severity of disease classification system. Critical care medicine, 13(10):818–829.
Kumar, A., Roberts, D., Wood, K. E., Light, B., Parrillo, J. E., Sharma, S., Suppes, R., Feinstein, D., Zanotti, S., Taiberg, L., et al. (2006). Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Critical care medicine, 34(6):1589–1596.
Le, S., Hoffman, J., Barton, C., Fitzgerald, J. C., Allen, A., Pellegrini, E., Calvert, J., and Das, R. (2019). Pediatric severe sepsis prediction using machine learning. Frontiers in Pediatrics, 7:413.
Levy, M. M., Evans, L. E., and Rhodes, A. (2018). The Surviving Sepsis Campaign Bundle: 2018 Update. Intensive care medicine, 44(6):925–928.
Machado, F. R., Cavalcanti, A. B., Bozza, F. A., Ferreira, E. M., Carrara, F. S. A., Sousa, J. L., Caixeta, N., Salomao, R., Angus, D. C., Azevedo, L. C. P., et al. (2017). The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study. The Lancet Infectious Diseases, 17(11):1180–1189.
Reyna, M., Josef, C., Jeter, R., Shashikumar, S., Westover, M., Nemati, S., Clifford, G., and Sharma, A. (2019). Early prediction of sepsis from clinical data: the PhysioNet/Computing in Cardiology Challenge 2019. Critical Care Medicine.
Royal College of Physicians (2017). National Early Warning Score (NEWS) 2: Standardising the assessment of acute-illness severity in the NHS.
Seymour, C. W., Gesten, F., Prescott, H. C., Friedrich, M. E., Iwashyna, T. J., Phillips, G. S., Lemeshow, S., Osborn, T., Terry, K. M., and Levy, M. M. (2017). Time to treatment and mortality during mandated emergency care for sepsis. New England Journal of Medicine, 376(23):2235–2244.
Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., Bellomo, R., Bernard, G. R., Chiche, J.-D., Coopersmith, C. M., et al. (2016). The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA: The Journal of the American Medical Association, 315(8):801–810.
Vincent, J.-L., Moreno, R., Takala, J., Willatts, S., De Mendonça, A., Bruining, H., Reinhart, C., Suter, P., and Thijs, L. (1996). The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive care medicine, 22(7):707–710.
Publicado
15/09/2020
Como Citar
SHIRAISHI, Diogo; MARUJO, Ernesto.
Predição de sepse em unidade de terapia intensiva: uma abordagem de aprendizado de máquina. In: SIMPÓSIO BRASILEIRO DE COMPUTAÇÃO APLICADA À SAÚDE (SBCAS), 20. , 2020, Evento Online.
Anais [...].
Porto Alegre: Sociedade Brasileira de Computação,
2020
.
p. 416-421.
ISSN 2763-8952.
DOI: https://doi.org/10.5753/sbcas.2020.11533.
