Implementing an intelligent diagnosis and treatment system for in-hospital cardiac arrest in the Utstein style: a multi-center case study

Abstract

Abstract Background Cardiac arrest presents a variety of causes and complexities, making it challenging to develop targeted treatment plans. Often, the original data are either inadequate or lack essential patient information. In this study, we introduce an intelligent system for diagnosing and treating in-hospital cardiac arrest (IHCA), aimed at improving the success rate of cardiopulmonary resuscitation and restoring spontaneous circulation. Methods To compensate for insufficient or incomplete data, a hybrid mega trend diffusion method was used to generate virtual samples, enhancing system performance. The core of the system is a modified episodic deep reinforcement learning module, which facilitates the diagnosis and treatment process while improving sample efficiency. Uncertainty analysis was performed using Monte Carlo simulations, and dependencies between different parameters were assessed using regular vine copula. The system's effectiveness was evaluated using ten years of data from Utstein-style IHCA registries across seven hospitals in China's Hebei Province. Results The system demonstrated improved performance compared to other models, particularly in scenarios with inadequate data or missing patient information. The average reward scores in two key stages increased by 2.3–9 and 9.9–23, respectively. Conclusions The intelligent diagnosis and treatment effectively addresses IHCA, providing reliable diagnosis and treatment plans in IHCA scenarios. Moreover, it can effectively induce cardiopulmonary resuscitation and restoration of spontaneous circulation processes even when original data are insufficient or basic patient information is missing.

Keywords

• In-hospital cardiac arrest
• Intelligent diagnosis and treatment system
• Hybrid mega trend diffusion
• Modified episodic deep reinforcement learning
• Uncertainty analysis