arXiv AI By Shehan Irteza Pranto, Joanna Yang, Joshua Lambert, Stuart L. Goldstein, Lili Chan, Girish N. Nadkarni, Tiago K. Colicchio, Javier A. Neyra, Jin Chen

Rolling Day-Wise Mortality Prediction in Critically Ill Patients With AKI on CRRT Utilizing Machine Pressure Waveforms

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This study develops a rolling day‑wise mortality prediction model for critically ill patients with acute kidney injury on continuous renal replacement therapy (CRRT) by incorporating minute‑level machine pressure waveforms alongside electronic health record (EHR) data. After cleaning the raw machine data—aligning it with therapy intervals, removing priming and downtime minutes, and denoising artifacts—the authors trained a transformer‑based stacked ensemble that fuses a sequence transformer with classical models using circuit‑instability features and clinical variables. In a multi‑center benchmark of 976 patients, the combined model achieved a one‑day mortality AUROC of 0.766, outperforming machine‑only (0.625) and EHR‑only (0.717) models, and SHAP analysis highlighted key pressure‑related features such as filter pressure, transmembrane pressure, and access‑to‑return difference. whyItMatters":"By integrating previously discarded CRRT machine data, the study provides a continuous, real‑time risk signal that could enable earlier detection of patient deterioration and improve mortality prediction in a high‑risk population."

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