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Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Prediction of survival for patients in intensive care units (ICUs) has been subject to intense research. However, no models exist that embrace the multiverse of data in ICUs. It is an open question whether deep learning methods using automated data integration with minimal pre-processing of mixed data domains such as free text, medical history and high-frequency data can provide discrete-time survival estimates for individual ICU patients. We trained a deep learning model on data from patients admitted to ten ICUs in the Capital Region of Denmark and the Region of Southern Denmark between 2011 and 2018. Inspired by natural language processing we mapped the electronic patient record data to an embedded representation and fed the data to a recurrent neural network with a multi-label output layer representing the chance of survival at different follow-up times. We evaluated the performance using the time-dependent concordance index. In addition, we quantified and visualized the drivers of survival predictions using the SHAP methodology. We included 37,355 admissions of 29,417 patients in our study. Our deep learning models outperformed traditional Cox proportional-hazard models with concordance index in the ranges 0.72\u20130.73, 0.71\u20130.72, 0.71, and 0.69\u20130.70, for models applied at baseline 0, 24, 48, and 72\u2009h, respectively. Deep learning models based on a combination of entity embeddings and survival modelling is a feasible approach to obtain individualized survival estimates in data-rich settings such as the ICU. 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AP reports grants from the Novo Nordisk Foundation. SB reports personal board of director fees from Intomics and Proscion as well as grants from the Novo Nordisk Foundation (grants NNF17OC0027594 and NNF14CC0001). The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The first and corresponding authors had full access to all the data in the study and had final responsibility for the decision to submit for publication. All other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"142"}}