A Self-Adaptive Frequency Domain Network for Continuous Intraoperative Hypotension Prediction

Intraoperative hypotension (IOH) is strongly associated with postoperative complications, including postoperative delirium and increased mortality, making its early prediction crucial in perioperative care. While several artificial intelligence-based models have been developed to provide IOH warnings, existing methods face limitations in incorporating both time and frequency domain information, capturing short- and long-term dependencies, and handling noise sensitivity in biosignal data. To address these challenges, we propose a novel Self-Adaptive Frequency Domain Network (SAFDNet). Specifically, SAFDNet integrates an adaptive spectral block, which leverages Fourier analysis to extract frequency-domain features and employs self-adaptive thresholding to mitigate noise. Additionally, an interactive attention block is introduced to capture both long-term and short-term dependencies in the data. Extensive internal and external validations on two large-scale real-world datasets demonstrate that SAFDNet achieves up to 97.3% AUROC in IOH early warning, outperforming state-of-the-art models. Furthermore, SAFDNet exhibits robust predictive performance and low sensitivity to noise, making it well-suited for practical clinical applications.