Academic Journal
TILTomorrow today: dynamic factors predicting changes in intracranial pressure treatment intensity after traumatic brain injury
| العنوان: | TILTomorrow today: dynamic factors predicting changes in intracranial pressure treatment intensity after traumatic brain injury |
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| المؤلفون: | Bhattacharyay S., van Leeuwen F. D., Beqiri E., Akerlund C. A. I., Wilson L., Steyerberg E. W., Nelson D. W., Maas A. I. R., Menon D. K., Ercole A., Zoerle T., Ziverte A., Zelinkova V., Zeiler F. A., Younsi A., Ylen P., Yang Z., Wolf S., Winzeck S., Williams G., Wiegers E., Whitehouse D., Wang K. K. W., Vulekovic P., Voormolen D., von Steinbuchel N., Volovici V., Vilcinis R., Vik A., Vespa P. M., Verheyden J., Velt K., Vega E., Vargiolu A., van Wijk R. P. J., Vyvere T. V., van Veen E., van Heugten C., Van Hecke W., van Essen T. A., van Erp I. A. M., van Dijck J. T. J. M., van der Naalt J., Van der Steen G., van der Jagt M., Vamos Z., Valeinis E., Vallance S., Vajkoczy P., Unterberg A., Tudora C. M., Trapani T., Tolias C., Timmers M., Tibboel D., Thomas M., Theadom A., Tenovuo O., Ao B. T., Thibaut A., Taylor M. S., Tamosuitis T., Tamas V., Takala R., Sundstrom N., Stocchetti N., Stewart W., Stevens R., Stanworth S., Stamatakis E., Sorinola A., Smielewski P., Skandsen T., Singh R. D., Sewalt C., Schwendenwein E., Schou R. F., Schoonman G., Schoechl H., Schmidt S., Schafer N., Sandor J., Sanchez-Porras R., Sakowitz O., Sahuquillo J., Rusnak M., Rueckert D., Rossi S., Rossaint R., Rosenthal G., Rosenlund C., Rosenfeld J. V., Rosand J., Roise O., Roe C., Rocka S., Ripatti S., Richter S., Richardson S., Rhodes J., Helmrich I. R., Rambadagalla M., Raj R., Ragauskas A., Radoi A., Puybasset L., Posti J. P., Pomposo I., Polinder S., Ples H., Pisica D., Pirinen M., Piippo-Karjalainen A., Peul W., Persona P., Perlbarg V., Perera N., Payen J. -F., Parizel P. M., Palotie A., Ortolano F., Oresic M., Olubukola O., Nyiradi J., Nieboer D., Newcombe V., Nelson D., Negru A., Murray L., Muraleedharan V., Misset B., Mikolic A., Menovsky T., Menon D., Melegh B., McMahon C., Mattern J., Marechal H., Martino C., Manley G., Manara A., Majdan M., Maegele M., Castano-Leon A. M., Lingsma H., Lightfoot R., Levi L., Lejeune A., Legrand V., Lefering R., Ledoux D., Lecky F., Laureys S., Lanyon L., Lagares A., Kowark A., Kovacs N., Koskinen L. -O., Kornaropoulos E., Kondziella D., Kompanje E., Kolias A. G., Karan M., Jones K., Johnson F., Jiang J. -Y., Jarrett M., Jankowski S., Jacobs B., Hutchinson P. J., Huijben J., Horton L., Helseth E., Helbok R., Haitsma I., Haagsma J. A., Gupta D., Gruen R. L., Grossi F., Gravesteijn B., Gratz J., Gomez P. A., Golubovic J., Glocker B., Giga L., Ghuysen A., George P., Gao G., Gantner D., Galanaud D., Gagliardo P., Furmanov A., Frisvold S., Foks K., Feigin V. L., Fabricius M., Ezer E., Esser P., Duliere G. -L., Dreier J., Donoghue E., Dixit A., Dilvesi D., Depreitere B., Boogert H. D., Corte F. D., Degos V., De Keyser V., Dawes H., Dark P., Dahyot-Fizelier C., Czosnyka M., Czeiter E., Curry N., Covic A., Correia M., Cooper J. D., Coles J., Coburn M., Clusmann H., Citerio G., Chieregato A., Chevallard G., Cavallo S., Carbonara M., Lozano G. C., Cameron P., Calvi M. R., Calappi E., Caccioppola A., Cabeleira M., Bullinger M., Buki A., Brorsson C., Brooker J., Brinck V., Brazinova A., Bragge P., Blaabjerg M., Beretta L., Berardino M., Benali H., Belli A., Bellander B. -M., Beer R., Beauvais R., Barzo P., Bartels R., Azzolini M. L., Azouvi P., Audibert G., Antoni A., Anke A., Andreassen L., Andelic N., Amrein K., Akerlund C. |
| المساهمون: | Bhattacharyay, S, van Leeuwen, F, Beqiri, E, Akerlund, C, Wilson, L, Steyerberg, E, Nelson, D, Maas, A, Menon, D, Ercole, A, Zoerle, T, Ziverte, A, Zelinkova, V, Zeiler, F, Younsi, A, Ylen, P, Yang, Z, Wolf, S, Winzeck, S, Williams, G, Wiegers, E, Whitehouse, D, Wang, K, Vulekovic, P, Voormolen, D, von Steinbuchel, N, Volovici, V, Vilcinis, R, Vik, A, Vespa, P, Verheyden, J, Velt, K, Vega, E, Vargiolu, A, van Wijk, R, Vyvere, T, van Veen, E, van Heugten, C, Van Hecke, W, van Essen, T, van Erp, I, van Dijck, J, van der Naalt, J, Van der Steen, G, van der Jagt, M, Vamos, Z, Valeinis, E, Vallance, S, Vajkoczy, P, Unterberg, A, Tudora, C, Trapani, T, Tolias, C, Timmers, M, Tibboel, D, Thomas, M, Theadom, A, Tenovuo, O, Ao, B, Thibaut, A, Taylor, M, Tamosuitis, T, Tamas, V, Takala, R, Sundstrom, N, Stocchetti, N, Stewart, W, Stevens, R, Stanworth, S, Stamatakis, E, Sorinola, A, Smielewski, P, Skandsen, T, Singh, R, Sewalt, C, Schwendenwein, E, Schou, R, Schoonman, G, Schoechl, H, Schmidt, S, Schafer, N, Sandor, J, Sanchez-Porras, R, Sakowitz, O, Sahuquillo, J, Rusnak, M, Rueckert, D, Rossi, S, Rossaint, R, Rosenthal, G, Rosenlund, C, Rosenfeld, J, Rosand, J, Roise, O, Roe, C, Rocka, S, Ripatti, S, Richter, S, Richardson, S, Rhodes, J |
| بيانات النشر: | Nature Research GB |
| سنة النشر: | 2025 |
| المجموعة: | Università degli Studi di Milano-Bicocca: BOA (Bicocca Open Archive) |
| مصطلحات موضوعية: | Data mining, Intensive care unit, Intracranial pressure, Machine learning, Therapy intensity level, Traumatic brain injury |
| الوصف: | Practices for controlling intracranial pressure (ICP) in traumatic brain injury (TBI) patients admitted to the intensive care unit (ICU) vary considerably between centres. To help understand the rational basis for such variance in care, this study aims to identify the patient-level predictors of changes in ICP management. We extracted all heterogeneous data (2008 pre-ICU and ICU variables) collected from a prospective cohort (n = 844, 51 ICUs) of ICP-monitored TBI patients in the Collaborative European NeuroTrauma Effectiveness Research in TBI study. We developed the TILTomorrow modelling strategy, which leverages recurrent neural networks to map a token-embedded time series representation of all variables (including missing values) to an ordinal, dynamic prediction of the following day’s five-category therapy intensity level (TIL(Basic)) score. With 20 repeats of fivefold cross-validation, we trained TILTomorrow on different variable sets and applied the TimeSHAP (temporal extension of SHapley Additive exPlanations) algorithm to estimate variable contributions towards predictions of next-day changes in TIL(Basic). Based on Somers’ Dxy, the full range of variables explained 68% (95% CI 65–72%) of the ordinal variation in next-day changes in TIL(Basic) on day one and up to 51% (95% CI 45–56%) thereafter, when changes in TIL(Basic) became less frequent. Up to 81% (95% CI 78–85%) of this explanation could be derived from non-treatment variables (i.e., markers of pathophysiology and injury severity), but the prior trajectory of ICU management significantly improved prediction of future de-escalations in ICP-targeted treatment. Whilst there was no significant difference in the predictive discriminability (i.e., area under receiver operating characteristic curve) between next-day escalations (0.80 [95% CI 0.77–0.84]) and de-escalations (0.79 [95% CI 0.76–0.82]) in TIL(Basic) after day two, we found specific predictor effects to be more robust with de-escalations. The most important predictors of day-to-day changes in ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | ELETTRONICO |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/39747195; volume:15; issue:1; journal:SCIENTIFIC REPORTS; https://hdl.handle.net/10281/536941 |
| DOI: | 10.1038/s41598-024-83862-x |
| الاتاحة: | https://hdl.handle.net/10281/536941 https://doi.org/10.1038/s41598-024-83862-x |
| Rights: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.6666E85D |
| قاعدة البيانات: | BASE |
| DOI: | 10.1038/s41598-024-83862-x |
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