Causal Structure of Brain Physiology after Brain Injury from Subarachnoid Hemorrhage.
High frequency physiologic data are routinely generated for intensive care patients. While massive amounts of data make it difficult for clinicians to extract meaningful signals, these data could provide insight into the state of critically ill patients and guide interventions. We develop uniquely customized computational methods to uncover the causal structure within systemic and brain physiologic measures recorded in a neurological intensive care unit after subarachnoid hemorrhage. While the data have many missing values, poor signal-to-noise ratio, and are composed from a heterogeneous patient population, our advanced imputation and causal inference techniques enable physiologic models to be learned for individuals. Our analyses confirm that complex physiologic relationships including demand and supply of oxygen underlie brain oxygen measurements and that mechanisms for brain swelling early after injury may differ from those that develop in a delayed fashion. These inference methods will enable wider use of ICU data to understand patient physiology.
Division of Critical Care Neurology, Department of Neurology, Columbia University, New York, NY, United States of America.
Jan
J
Claassen
Computer Science Department, Stevens Institute of Technology, Hoboken, NJ, United States of America.
Shah Atiqur
SA
Rahman
Computer Science Department, Stevens Institute of Technology, Hoboken, NJ, United States of America.
Yuxiao
Y
Huang
Division of Critical Care Neurology, Department of Neurology, Columbia University, New York, NY, United States of America.
Hans-Peter
HP
Frey
Division of Critical Care Neurology, Department of Neurology, Columbia University, New York, NY, United States of America.
J Michael
JM
Schmidt
Department of Biomedical Informatics, Columbia University, New York, NY, United States of America.
David
D
Albers
Division of Critical Care Neurology, Department of Neurology, Columbia University, New York, NY, United States of America.
Cristina Maria
CM
Falo
Division of Critical Care Neurology, Department of Neurology, Columbia University, New York, NY, United States of America.
Soojin
S
Park
Division of Critical Care Neurology, Department of Neurology, Columbia University, New York, NY, United States of America.
Sachin
S
Agarwal
Department of Neurosurgery, Columbia University, New York, NY, United States of America.
E Sander
ES
Connolly
Computer Science Department, Stevens Institute of Technology, Hoboken, NJ, United States of America.
Samantha
S
Kleinberg
D001921:Brain / Q000503:physiopathology*; D001930:Brain Injuries / Q000209:etiology* / Q000503:physiopathology*; D003422:Critical Care; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009424:Nervous System Physiological Phenomena; D059629:Signal-To-Noise Ratio; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000503:physiopathology*