A machine learning-based model for 1-year mortality prediction in patients admitted to an Intensive Care Unit with a diagnosis of sepsis.

INTRODUCTION

Sepsis is associated to a high mortality rate, and its severity must be evaluated quickly. The severity of illness scores used are intended to be applicable to all patient populations, and generally evaluate in-hospital mortality. However, patients with sepsis continue to be at risk of death after hospital discharge.

OBJECTIVE

To develop a model for predicting 1-year mortality in critical patients diagnosed with sepsis.

PATIENTS

The data corresponding to 5650 admissions of patients with sepsis from the Medical Information Mart for Intensive Care (MIMIC-III) database were evaluated, randomly divided as follows: 70% for training and 30% for validation.

DESIGN

A retrospective register-based cohort study was carried out. The clinical information of the first 24h after admission was used to develop a 1-year mortality prediction model based on Stochastic Gradient Boosting (SGB) methodology. Variable selection was addressed using Least Absolute Shrinkage and Selection Operator (LASSO) and SGB variable importance methodologies. The predictive power was evaluated using the area under the ROC curve (AUROC).

RESULTS

An AUROC of 0.8039 (95% confidence interval (CI): [0.8033 0.8045]) was obtained in the validation subset. The model exceeded the predictive performances obtained with traditional severity of disease scores in the same subset.

CONCLUSION

The use of assembly algorithms, such as SGB, for the generation of a customized model for sepsis yields more accurate 1-year mortality prediction than the traditional scoring systems such as SAPS II, SOFA or OASIS.