Three Real-world Studies Based On MIMIIC Database

OBJECTIVE Through the real-world studies based on big data in critical care medicine,we explore the data mining of critical care medicine databases and processing methods of data.On the other hand,we provide information and reference for clinical practice and decision-making by explaining these clinical problems.METHODS We used structured query language for data mining in critical care medicine databases.After mining,we used statistics software to perform data cleaning,processing and analysis,and conclude.RESULTS Part One: Differences in microbiology between alcohol abuse and no alcohol abuse in adult ICU patients Patients in the alcohol abuse group were more likely to use mechanical ventilation(47.1% vs.52.7%,P < 0.001).For blood samples,the proportion of patients with gramnegative bacteria in the no alcohol abuse group was higher(P < 0.001),but the proportion of patients with gram-positive bacteria was lower(P < 0.01).Part Two: Timing of continuous renal replacement therapy in patients with severe acute pancreatitis Cox regression showed that congestive heart failure(HR 4.431;95% CI 1.583,12.396;P = 0.005)and the max bicarbonate level(HR 0.827;95% CI 0.726,0.942;P = 0.004)at ICU admission was related to the patient’s prognosis,while the CRRT start time(HR 0.940;95% CI 0.810,1.092;P = 0.421)had no statistically significant correlation with patient prognosis.Part Three: Relationship between early serum sodium and potassium levels and the severity of AKI and prognosis in oliguric AKI patients Patients with potassium > 4.6mmol/L were more likely to progress to AKI stage III or death than patients with potassium ≤ 4.6mmol/L(overall P < 0.0001).Patients with odium < 137mmol/L or > 141mmol/L had a higher risk of progressing to AKI stage III(overall P = 0.00023)and risk of death(overall P < 0.0001)than other patients.CONCLUSION 1.In adult ICU,alcohol abuse increased the probability of using mechanical ventilation.Those patients with alcohol abuse with blood infections were less likely to be infected with gram-negative bacteria but had a higher probability of gram-positive bacteria.2.The timing of CRRT intervention had no significant effect on the prognosis of patients with severe acute pancreatitis.Congestive heart failure and bicarbonate levels at ICU admission might be related to the prognosis of patients.3.Before AKI diagnosis,abnormal serum sodium or potassium levels were more likely to be related to AKI progression and poor prognosis.Low sodium and high potassium levels were more likely to progress to these events.