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Representing Injuries in Trauma Patients: Development and Evaluation of Embeddings for Injuries (Preprint)

Szolnoky, Kelvin ; Attergrim, Jonatan ; Ashfaq, Awais ; Linusson, Henrik ; Gerdin Wärnberg, Martin and Berg, Johanna LU orcid (2026)
Abstract
Background:
Trauma patients present with heterogeneous injury patterns that are challenging to represent in statistical models. Traditional approaches either use high-dimensional one-hot encoding, resulting in sparse features, or aggregate injuries into summary scores that lose patient-specific detail.

Objective:
This study developed data-driven ICD-10 embeddings for trauma injuries and evaluated their ability to preserve injury information.

Methods:
Using the National Trauma Data Bank, we trained autoencoder models on all trauma patients from 2018 to generate dense vector representations of ICD-10 injury codes. We evaluated embeddings of dimensions 2, 4, 8, 16, and 32 against one-hot encoding using three... (More)
Background:
Trauma patients present with heterogeneous injury patterns that are challenging to represent in statistical models. Traditional approaches either use high-dimensional one-hot encoding, resulting in sparse features, or aggregate injuries into summary scores that lose patient-specific detail.

Objective:
This study developed data-driven ICD-10 embeddings for trauma injuries and evaluated their ability to preserve injury information.

Methods:
Using the National Trauma Data Bank, we trained autoencoder models on all trauma patients from 2018 to generate dense vector representations of ICD-10 injury codes. We evaluated embeddings of dimensions 2, 4, 8, 16, and 32 against one-hot encoding using three prediction tasks: in-hospital mortality, emergency department disposition, and blood transfusion within 24 hours. For each hospital included, we trained separate logistic regression and LightGBM models using 2018 data from that hospital, then evaluated performance on 2019 data from the same hospital. Performance was measured using area under the receiver operating characteristic curve (AUC) and stratified by hospital size.

Results:
In LightGBM models, 8-dimensional embeddings improved AUC compared to one-hot encoding by 0.08 (95% CI: 0.06, 0.10) in small hospitals, 0.03 (0.02, 0.04) in medium hospitals, and 0.02 (0.01, 0.02) in large hospitals, with comparable performance in major hospitals (0.00 [-0.01, 0.01]). In logistic regression, 32-dimensional embeddings showed AUC improvements of 0.03 (0.01, 0.05), 0.02 (0.01, 0.03), and 0.02 (0.02, 0.03) for small, medium, and large hospitals respectively, with similar performance in major hospitals (0.01 [0.00, 0.01]).

Conclusions:
ICD-10 code injury embeddings with ≥8 dimensions preserve clinically relevant information and can outperform one-hot encoding while reducing dimensionality. The embeddings and software are openly available to support further trauma research and applications. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
type
Working paper/Preprint
publication status
submitted
subject
publisher
JMIR Publications Inc.
DOI
10.2196/preprints.91298
language
English
LU publication?
yes
id
90915cbc-eab6-4414-8f4a-04279c084334
date added to LUP
2026-03-04 20:20:36
date last changed
2026-03-05 08:35:09
@misc{90915cbc-eab6-4414-8f4a-04279c084334,
  abstract     = {{Background:<br/>Trauma patients present with heterogeneous injury patterns that are challenging to represent in statistical models. Traditional approaches either use high-dimensional one-hot encoding, resulting in sparse features, or aggregate injuries into summary scores that lose patient-specific detail.<br/><br/>Objective:<br/>This study developed data-driven ICD-10 embeddings for trauma injuries and evaluated their ability to preserve injury information.<br/><br/>Methods:<br/>Using the National Trauma Data Bank, we trained autoencoder models on all trauma patients from 2018 to generate dense vector representations of ICD-10 injury codes. We evaluated embeddings of dimensions 2, 4, 8, 16, and 32 against one-hot encoding using three prediction tasks: in-hospital mortality, emergency department disposition, and blood transfusion within 24 hours. For each hospital included, we trained separate logistic regression and LightGBM models using 2018 data from that hospital, then evaluated performance on 2019 data from the same hospital. Performance was measured using area under the receiver operating characteristic curve (AUC) and stratified by hospital size.<br/><br/>Results:<br/>In LightGBM models, 8-dimensional embeddings improved AUC compared to one-hot encoding by 0.08 (95% CI: 0.06, 0.10) in small hospitals, 0.03 (0.02, 0.04) in medium hospitals, and 0.02 (0.01, 0.02) in large hospitals, with comparable performance in major hospitals (0.00 [-0.01, 0.01]). In logistic regression, 32-dimensional embeddings showed AUC improvements of 0.03 (0.01, 0.05), 0.02 (0.01, 0.03), and 0.02 (0.02, 0.03) for small, medium, and large hospitals respectively, with similar performance in major hospitals (0.01 [0.00, 0.01]).<br/><br/>Conclusions:<br/>ICD-10 code injury embeddings with ≥8 dimensions preserve clinically relevant information and can outperform one-hot encoding while reducing dimensionality. The embeddings and software are openly available to support further trauma research and applications.}},
  author       = {{Szolnoky, Kelvin and Attergrim, Jonatan and Ashfaq, Awais and Linusson, Henrik and Gerdin Wärnberg, Martin and Berg, Johanna}},
  language     = {{eng}},
  month        = {{01}},
  note         = {{Preprint}},
  publisher    = {{JMIR Publications Inc.}},
  title        = {{Representing Injuries in Trauma Patients: Development and Evaluation of Embeddings for Injuries (Preprint)}},
  url          = {{http://dx.doi.org/10.2196/preprints.91298}},
  doi          = {{10.2196/preprints.91298}},
  year         = {{2026}},
}