Intradialytic Hypotension Frequency Prediction Using Generalizable Neighborhood Reasoning on Temporal Patient Knowledge Graph

Intradialytic hypotension (IDH) is a common complication among hemodialysis patients, adversely affecting quality of life and elevating mortality risk. IDH prediction enables physicians to take proactive measures, effectively reducing its occurrence. However, most prediction works rely on machine learning models, with a focus on real-time or session-level IDH. Hemodialysis patient data is multi-type and temporal, necessitating research on patient condition representation and temporal information utilization. Knowledge graphs (KGs) offer flexible data modeling and encompass rich structured information. This study represents patients using KGs and reason on graph structures to predict IDH. To study monthly IDH and utilize temporal information, a temporal patient KG is constructed. Patient KGs are first built at the monthly granularity based on data of 532 patients between January 2017 and August 2022. Six sequential monthly KGs are then combined into an observation window, resulting in a temporal KG dataset of 15,807 independent windows from 458 patients. The aim of this study is to utilize information from multiple months within a window to predict frequent IDH in the last month. However, the characteristics of IDH scenario and generalizability requirement pose challenges for the application of general KG reasoning models. Therefore, we adopt neighborhood-based KG reasoning and devise a visible feature guided patient-centric graph convolution to obtain patients' generalizable representations. Finally, patient representations in a window are fused using a sequential model, and processed by a prediction MLP to obtain the prediction results. Compared to 7 classic machine learning models, our model demonstrates superior performance in comprehensive metrics such as accuracy and F1 score.