Monitoring ICU Mortality Risk with A Long Short-Term Memory Recurrent Neural Network.

In intensive care units (ICU), mortality prediction is a critical factor not only for effective medical intervention but also for allocation of clinical resources. Structured electronic health records (EHR) contain valuable information for assessing mortality risk in ICU patients, but current mortality prediction models usually require laborious human-engineered features. Furthermore, substantial missing data in EHR is a common problem for both the construction and implementation of a prediction model.Inspired by language-related models, we design a new framework for dynamic monitoring of patients' mortality risk. Our framework uses the bag-of-words representation for all relevant medical events based on most recent history as inputs. By design, it is robust to missing data in EHR and can be easily implemented as an instant scoring system to monitor the medical development of all ICU patients. Specifically, our model uses latent semantic analysis (LSA) to encode the patients' states into low-dimensional embeddings, which are further fed to long short-term memory networks for mortality risk prediction. Our results show that the deep learning based framework performs better than the existing severity scoring system, SAPS-II. We observe that bidirectional long short-term memory demonstrates superior performance, probably due to the successful capture of both forward and backward temporal dependencies.