%0 Journal Article
%T The Intervention Threshold for Intracranial Pressure of Traumatic Brain Injury Patients Can Be Determined by Clustering Algorithms and Is Observed to Be 13 mm Hg
%J -
%D 2019
%X During treatment in an intensive care unit (ICU), traumatic brain injury (TBI) patients sometimes suffer an increase in intracranial pressure (ICP). An increase beyond a currently unknown and to-be-determined threshold is very often life-threatening and requires intervention by the clinical staff. Because this threshold value is considered unknown, ¡®conventional wisdom¡¯ of practitioners argue it to be 20 mm Hg. No published studies include statistical methods that could supply a rigorous outcome for the threshold value. Here, we use a clustering algorithm (K-means clustering) to find three-dimensional clusters of the 984 triples of ICP, temperature and patient state index (PSI, a proxy for sedation level). The algorithm outputs three clusters and two gaps. One gap separates two clusters from a third and is almost planar, and perpendicular to the ICP axis (implying a threshold across all temperatures and all sedation levels); the other is perpendicular to the temperature axis, which terminates at the aforementioned gap. The first gap provides a statistically rigorous threshold of 13.625 mm Hg for ICP intervention. The second gap defines a threshold temperature (36.5¡ãC). The gap between the two temperature regimes does not continue into Cluster 3, implying that the intervention threshold for ICP is independent of temperature
%K Intracranial Pressure
%K Traumatic Brain Injury
%K Clustering Algorithms
%K Patient State Index
%K Akaike¡¯s Information Criterion
%K ICP Intervention Threshold
%K K-means Clustering
%U http://www.sciencepublishinggroup.com/journal/paperinfo?journalid=151&doi=10.11648/j.cmr.20190801.12