Decision making assumes a critical role in the Intensive Medicine. Data Mining is emerging in the clinical area to provide processes and technologies for transforming data into useful knowledge to support clinical decision makers. Appling clustering techniques to the data available on the patients admitted into Intensive Care Units and knowing which ones correspond to readmissions, it is possible to create meaningful clusters that will represent the base characteristics of readmitted patients. Thus, exploring common characteristics it is possible to prevent discharges that will result into readmissions and then improve the patient outcome and reduce costs. Moreover, readmitted patients present greater difficulty to be recovered. In this work it was followed the Stability and Workload Index for Transfer (SWIFT). A subset of variables from SWIFT was combined with the results from laboratory exams, namely the Lactic Acid and the Leucocytes values, in order to create clusters to identify, in the moment of discharge, patients that probably will be readmitted.

Nowadays the efficiency of costs and resources planning in hospitals embody a critical role in the management of these units. Length Of Stay (LOS) is a good metric when the goal is to decrease costs and to optimize resources. In Intensive Care Units (ICU) optimization assumes even a greater importance derived from the high costs associated to inpatients. This study presents two data mining approaches to predict LOS in an ICU. The first approach considered the admission variables and some other physiologic variables collected during the first 24 hours of inpatient. The second approach considered admission data and supplementary clinical data of the patient (vital signs and laboratory results) collected in real-time. The results achieved in the first approach are very poor (accuracy of 73 %). However, when the prediction is made using the data collected in real-time, the results are very interesting (sensitivity of 96.104%). The models induced in second experiment are sensitive to the patient clinical situation and can predict LOS according to the monitored variables. Models for predicting LOS at admission are not suited to the ICU particularities. Alternatively, they should be induced in real-time, using online-learning and considering the most recent patient condition when the model is induced.

With a constant increasing in the health expenses and the aggravation of the global economic situation, managing costs and resources in healthcare is nowadays an essential point in the management of hospitals. The goal of this work is to apply clustering techniques to data collected in real-time about readmitted patients in Intensive Care Units in order to know some possible features that affect readmissions in this area. By knowing the common characteristics of readmitted patients it will be possible helping to improve patient outcome, reduce costs and prevent future readmissions. In this study, it was followed the Stability and Workload Index for Transfer (SWIFT) combined with the results of clinical tests for substances like lactic acid, leucocytes, bilirubin, platelets and creatinine. Attributes like sex, age and identification if the patient came from the chirurgical block were also considered in the characterization of potential readmissions. In general, all the models presented very good results being the Davies-Bouldin index lower than 0.82, where the best index was 0.425.

No abstract

With a constant increasing in the health expenses and the aggravation of the global economic situation, managing costs and resources in healthcare is nowadays an essential point in the management of hospitals. The goal of this work is to apply clustering techniques to data collected in real-time about readmitted patients in Intensive Care Units in order to know some possible features that affect readmissions in this area. By knowing the common characteristics of readmitted patients it will be possible helping to improve patient outcome, reduce costs and prevent future readmissions. In this study, it was followed the Stability and Workload Index for Transfer (SWIFT) combined with the results of clinical tests for substances like lactic acid, leucocytes, bilirubin, platelets and creatinine. Attributes like sex, age and identification if the patient came from the chirurgical block were also considered in the characterization of potential readmissions. In general, all the models presented very good results being the Davies-Bouldin index lower than 0.82, where the best index was 0.425.