🩺 MIMIC-IV Extended

Overview

Extended MIMIC-IV analysis, 100 patients, 15 tables, building on MIMIC-IV Lite with additional clinical data streams.

Data Structure

Table	What It Adds
Chartevents	Vital signs: heart rate, blood pressure, SpO₂, temperature
Microbiology	Culture results: organism identification, resistance patterns
ICD Procedures	Surgical and diagnostic procedure codes
Transfers	Ward-to-ward movements: ICU ↔ floor transitions
Fluid Balance (I/O)	Intake/output records: IV fluids, urine output
Pharmacy	Detailed medication dispensing: doses, routes, timing
Services	Clinical service assignments: surgery, medicine, consults

Causal Reasoning Model

Eight pathways, three from Lite plus five new ones:

1. Sepsis: infection → organ dysfunction → delayed treatment 2. Timing Delays: weekend/night → delayed labs/antibiotics 3. Comorbidity: elderly + multi-organ involvement 4. Hemodynamic Deterioration: vital sign decline → vasopressor need 5. Culture-Confirmed Infection: positive cultures → targeted therapy delays 6. Surgical Complication: procedure → post-op complications 7. Care Fragmentation: multiple ward transfers → coordination failures 8. Fluid Overload: positive fluid balance → respiratory compromise

Sample Questions

• "Which admissions had hemodynamic instability, and how did it affect outcomes?"
• "How did ward transfers contribute to care fragmentation?"
• "What role did fluid overload play in prolonged ICU stays?"

Prescriptive Recommendations

Ask what to do: get clinical intervention recommendations with cost-benefit analysis. The engine recommends antibiotic initiation for sepsis, ICU escalation for hemodynamic instability, and antibiotic de-escalation when culture results confirm the organism.

• "What clinical actions should we take for sepsis patients with delayed antibiotics?"
• "Which admissions should be escalated to ICU based on hemodynamic instability?"