OmniTFT: Omni Target Forecasting for Vital Signs and Laboratory Result Trajectories in Multi Center ICU Data

Accurate multivariate time-series prediction of vital signs and laboratory results is crucial for early intervention and precision medicine in intensive care units (ICUs). However, vital signs are often noisy and exhibit rapid fluctuations, while laboratory tests suffer from missing values, measurement lags, and device-specific bias, making integrative forecasting highly challenging. To address these issues, we propose OmniTFT, a deep learning framework that jointly learns and forecasts high-frequency vital signs and sparsely sampled laboratory results based on the Temporal Fusion Transformer (TFT). Specifically, OmniTFT implements four novel strategies to enhance performance: sliding window equalized sampling to balance physiological states, frequency-aware embedding shrinkage to stabilize rare-class representations, hierarchical variable selection to guide model attention toward informative feature clusters, and influence-aligned attention calibration to enhance robustness during abrupt physiological changes. By reducing the reliance on target-specific architectures and extensive feature engineering, OmniTFT enables unified modeling of multiple heterogeneous clinical targets while preserving cross-institutional generalizability. Across forecasting tasks, OmniTFT achieves substantial performance improvement for both vital signs and laboratory results on the MIMIC-III, MIMIC-IV, and eICU datasets. Its attention patterns are interpretable and consistent with known pathophysiology, underscoring its potential utility for quantitative decision support in clinical care.