A novel neural network for improved in-hospital mortality prediction with irregular and incomplete multivariate data

Accurate estimation of in-hospital mortality based on patients’ physiological time series data improves the performance of the clinical decision support systems and assists hospital providers in allocating resources. In practice, the data quality issues of missing values are ubiquitous in electronic health records (EHRs). Since the vital signs are usually observed with irregular temporal intervals and different sampling rates, it is challenging to predict clinical outcomes with sparse and incomplete multivariate time series. We propose an auto-regressive recurrent neural network (RNN) based model, dubbed the bi-directional recursive encoder–decoder network (BiRED), to jointly perform data imputation and mortality prediction. To capture complex patterns of medical time sequences, a 2D cross-regression with an RNN unit (2DCR-RNN) and an imputation block with an RNN unit (IB-RNN) are designed as the recurrent component of the encoder and decoder, respectively. Furthermore, a state initialization method is proposed to alleviate errors accumulated in the generated sequence. The experimental results on two real EHR datasets show that our proposed method can predict hospital mortality with high AUC scores.