Predicting Individual Patient Platelet Demand in a Large Tertiary Care Hospital Using Machine Learning.

Blood transfusion Donor management Machine learning Patient individual Platelet Platelet concentrates Platelet prediction

Journal

Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie
ISSN: 1660-3796
Titre abrégé: Transfus Med Hemother
Pays: Switzerland
ID NLM: 101176417

Informations de publication

Date de publication:
Aug 2023
Historique:
received: 19 10 2022
accepted: 29 11 2022
medline: 28 9 2023
pubmed: 28 9 2023
entrez: 28 9 2023
Statut: epublish

Résumé

An increasing shortage of donor blood is expected, considering the demographic change in Germany. Due to the short shelf life and varying daily fluctuations in consumption, the storage of platelet concentrates (PCs) becomes challenging. This emphasizes the need for reliable prediction of needed PCs for the blood bank inventories. Therefore, the objective of this study was to evaluate multimodal data from multiple source systems within a hospital to predict the number of platelet transfusions in 3 days on a per-patient level. Data were collected from 25,190 (42% female and 58% male) patients between 2017 and 2021. For each patient, the number of received PCs, platelet count blood tests, drugs causing thrombocytopenia, acute platelet diseases, procedures, age, gender, and the period of a patient's hospital stay were collected. Two models were trained on samples using a sliding window of 7 days as input and a day 3 target. The model predicts whether a patient will be transfused 3 days in the future. The model was trained with an excessive hyperparameter search using patient-level repeated 5-fold cross-validation to optimize the average macro F2-score. The trained models were tested on 5,022 unique patients. The best-performing model has a specificity of 0.99, a sensitivity of 0.37, an area under the precision-recall curve score of 0.45, an MCC score of 0.43, and an F1-score of 0.43. However, the model does not generalize well for cases when the need for a platelet transfusion is recognized. A patient AI-based platelet forecast could improve logistics management and reduce blood product waste. In this study, we build the first model to predict patient individual platelet demand. To the best of our knowledge, we are the first to introduce this approach. Our model predicts the need for platelet units for 3 days in the future. While sensitivity underperforms, specificity performs reliably. The model may be of clinical use as a pretest for potential patients needing a platelet transfusion within the next 3 days. As sensitivity needs to be improved, further studies should introduce deep learning and wider patient characterization to the methodological multimodal, multisource data approach. Furthermore, a hospital-wide consumption of PCs could be derived from individual predictions.

Identifiants

pubmed: 37767277
doi: 10.1159/000528428
pii: tmh-0050-0277
pmc: PMC10521242
doi:

Types de publication

Journal Article

Langues

eng

Pagination

277-285

Informations de copyright

Copyright © 2023 by The Author(s). Published by S. Karger AG, Basel.

Déclaration de conflit d'intérêts

The authors have no conflicts of interest to declare.

Références

Dtsch Arztebl Int. 2014 Nov 28;111(48):809-15
pubmed: 25512006
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2009 Jul;52(7):715-31
pubmed: 19572110
Haematologica. 2011 Jan;96(1):10-3
pubmed: 21193429
JMIR Med Inform. 2022 Feb 1;10(2):e29978
pubmed: 35103612
Ann Thorac Surg. 2021 Feb;111(2):607-614
pubmed: 32585201
Comput Biol Med. 2019 Oct;113:103415
pubmed: 31536834
Transfus Med Rev. 2021 Jan;35(1):37-45
pubmed: 33341326
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2008 Dec;51(12):1484
pubmed: 19137225
Crit Care. 2022 Feb 21;26(1):49
pubmed: 35189930
Ann Intern Med. 2015 Feb 03;162(3):205-13
pubmed: 25383671
Blood Adv. 2017 May 26;1(14):867-874
pubmed: 29296730
Transfusion. 2017 Jun;57(6):1347-1358
pubmed: 28150313
Transfus Med Hemother. 2010 Jun;37(3):141-148
pubmed: 20737017

Auteurs

Merlin Engelke (M)

University Medicine Essen, Institute for Artificial Intelligence in Medicine, Essen, Germany.
University Medicine Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen, Germany.

Christian Martin Brieske (CM)

University Medicine Essen, Institute for Transfusion Medicine, Essen, Germany.

Vicky Parmar (V)

University Medicine Essen, Institute for Artificial Intelligence in Medicine, Essen, Germany.
University Medicine Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen, Germany.

Nils Flaschel (N)

University Medicine Essen, Institute for Artificial Intelligence in Medicine, Essen, Germany.
University Medicine Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen, Germany.

Anisa Kureishi (A)

University Medicine Essen, Institute for Artificial Intelligence in Medicine, Essen, Germany.

Rene Hosch (R)

University Medicine Essen, Institute for Artificial Intelligence in Medicine, Essen, Germany.
University Medicine Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen, Germany.

Sven Koitka (S)

University Medicine Essen, Institute for Artificial Intelligence in Medicine, Essen, Germany.
University Medicine Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen, Germany.

Cynthia Sabrina Schmidt (CS)

University Medicine Essen, Institute for Transfusion Medicine, Essen, Germany.

Peter A Horn (PA)

University Medicine Essen, Institute for Transfusion Medicine, Essen, Germany.

Felix Nensa (F)

University Medicine Essen, Institute for Artificial Intelligence in Medicine, Essen, Germany.
University Medicine Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen, Germany.

Classifications MeSH