Prediction of Prognosis in Patients with Trauma by Using Machine Learning

Abstract

Background and Objectives: We developed a machine learning algorithm to analyze trauma-related data and predict the mortality and chronic care needs of patients with trauma. Materials and Methods: We recruited admitted patients with trauma during 2015 and 2016 and collected their clinical data. Then, we subjected this database to different machine learning techniques and chose the one with the highest accuracy by using cross-validation. The primary endpoint was mortality, and the secondary endpoint was requirement for chronic care. Results: Data of 5871 patients were collected. We then used the eXtreme Gradient Boosting (xGBT) machine learning model to create two algorithms: a complete model and a short-term model. The complete model exhibited an 86% recall for recovery, 30% for chronic care, 67% for mortality, and 80% for complications; the short-term model fitted for ED displayed an 89% recall for recovery, 25% for chronic care, and 41% for mortality. Conclusions: We developed a machine learning algorithm that displayed good recall for the healthy recovery group but unsatisfactory results for those requiring chronic care or having a risk of mortality. The prediction power of this algorithm may be improved by implementing features such as age group classification, severity selection, and score calibration of trauma-related variables.

Keywords: machine learning; mortality; prognostic predictor; trauma; trauma score.

Figure 1

Flowchart from the database of beginning, through data optimization and training model to final clinical utilization.

Figure 2

Comparing different analytic machine techniques for better predicting accuracy.

Figure 3

Algorithm of complete model: initial data collection from patient arriving through hospitalization to final prognosis prediction.

Figure 4

Algorithm of short-term model: initial data collection from patients arriving to prognosis prediction and skipping hospitalization.