摘要目的 深度解析重症监护医学信息数据库Ⅲ(MIMIC-Ⅲ)患者疾病谱,为基于MIMIC-Ⅲ数据库解决临床科研问题的临床医生及工程师提供相关数据参考.方法 利用探索性数据分析方法,探究MIMIC-Ⅲ数据库中各年龄层患者(不包括新生儿)疾病及急症分布特点;基于相同方法,分析新生儿孕周、体重、重症加强治疗病房(ICU)住院时间等数据的分布特点.结果 MIMIC-Ⅲ数据库中首次入院46 428例患者,49 214例次ICU记录.其中男性26 076例,女性20 352例;中位年龄为60.5(38.6,75.6)岁;分布在61～80岁的患者最多.疾病谱分析中,第一诊断以循环系统疾病患者占比最大(占32%),其次为损伤和中毒(占14%)、消化系统疾病(占8%)、肿瘤(占7%)、呼吸系统疾病(占6%)等.循环系统疾病中缺血性心脏病患者占比最大(占42%),患者比例随年龄增加到60～70岁达最大值后逐渐下降;而脑血管疾病患者比例则随年龄增长呈先下降后升高趋势,并且是循环系统疾病死亡的主要原因(占22.5%).损伤和中毒患者随年龄增加比例呈明显下降趋势.消化系统疾病较总人群分布偏年轻化(50～60岁者最多),非感染性肠炎和结肠炎是其主要死亡原因(ICU病死率18.3%).在感染患者中以呼吸系统感染为主(占34%), 但循环系统感染是其主要死亡原因(ICU病死率25.6%).监护室新生儿中早产儿占82%,随孕龄增加,ICU住院时间减少,且病死率下降.结论 通过对MIMIC-Ⅲ数据库患者疾病谱进行深度解析,能为相关领域研究者提供一定数据参考,利于先期掌握研究目标对象的体量和分布概况以及开展下一步研究,同时可了解探索性数据分析技术在医疗数据分析领域的重要作用,为利用电子健康档案进行数据研究提供便利.

abstractsObjective To study the distribution of diseases in Medical Information Mart for Intensive Care Ⅲ(MIMIC-Ⅲ) database in order to provide reference for clinicians and engineers who use MIMIC-Ⅲ database to solve clinical research problems. Methods The exploratory data analysis technologies were used to explore the distribution characteristics of diseases and emergencies of patients (excluding newborns) in MIMIC-Ⅲ database were explored; then, neonatal gestational age, weight, length of hospital stay in intensive care unit (ICU) were analyzed with the same method. Results In the MIMIC-Ⅲ database, 46 428 patients were admitted for the first time, and 49 214 ICU records were recorded. There were 26 076 males and 20 352 females; the median age was 60.5 (38.6, 75.6) years, and most patients were between 60 and 80 years old. The first diagnosis in the disease spectrum analysis was firstly ranked by circulatory diseases (32%), followed by injury and poisoning (14%), digestive system disease (8%), tumor (7%), respiratory disease (6%) and so on. Patients with ischemic heart disease accounted for the largest proportion of circulatory disease (42%), the proportion of these patients gradually increased with age of 60-70 years old, then decreased. However, the proportion of patients with cerebrovascular disease declined first and then increased with age, which was the main cause of death of circulatory system disease (ICU mortality was 22.5%). Injury and poisoning patients showed a significant decrease with age. Digestive system diseases were younger than the general population (most people aged between 50 to 60 years), and non-infectious enteritis and colitis were the main causes of death (ICU mortality was 18.3%). Respiratory infections were predominant in infected patients (34%), but circulatory system infections were the main cause of death (ICU mortality was 25.6%). Secondly, in the neonatal care unit, premature infants accounted for the vast majority (82%). As the gestational age increased, the duration of ICU was decreased, and the mortality was decreased. Conclusions The diseases distribution of patients can be provided by MIMIC-Ⅲ database, which helps to grasp the overview of the volume and age distribution of the target patients in advance, and carry out the next step of research. Meanwhile, it points out the important role of exploratory data analysis in electronic health records analysis.