Predicting intraoperative hypotension using deep learning with waveforms of arterial blood pressure, electroencephalogram, and electrocardiogram: Retrospective study

PLoS One. 2022 Aug 9;17(8):e0272055. doi: 10.1371/journal.pone.0272055. eCollection 2022.

Abstract

To develop deep learning models for predicting Interoperative hypotension (IOH) using waveforms from arterial blood pressure (ABP), electrocardiogram (ECG), and electroencephalogram (EEG), and to determine whether combination ABP with EEG or CG improves model performance. Data were retrieved from VitalDB, a public data repository of vital signs taken during surgeries in 10 operating rooms at Seoul National University Hospital from January 6, 2005, to March 1, 2014. Retrospective data from 14,140 adult patients undergoing non-cardiac surgery with general anaesthesia were used. The predictive performances of models trained with different combinations of waveforms were evaluated and compared at time points at 3, 5, 10, 15 minutes before the event. The performance was calculated by area under the receiver operating characteristic (AUROC), area under the precision-recall curve (AUPRC), sensitivity and specificity. The model performance was better in the model using both ABP and EEG waveforms than in all other models at all time points (3, 5, 10, and 15 minutes before an event) Using high-fidelity ABP and EEG waveforms, the model predicted IOH with a AUROC and AUPRC of 0.935 [0.932 to 0.938] and 0.882 [0.876 to 0.887] at 5 minutes before an IOH event. The output of both ABP and EEG was more calibrated than that using other combinations or ABP alone. The results demonstrate that a predictive deep neural network can be trained using ABP, ECG, and EEG waveforms, and the combination of ABP and EEG improves model performance and calibration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arterial Pressure / physiology
  • Blood Pressure
  • Deep Learning*
  • Electrocardiography / methods
  • Electroencephalography
  • Humans
  • Hypotension* / diagnosis
  • Retrospective Studies

Grants and funding

This research was supported by the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT (Grant No. NRF-2020M3E5D9079768), and a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant HI21C0852). Medical AI, Co. Ltd. provided support in the form of salaries for authors Y-YJ, J-HJ, and J-MK, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.