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A Machine Learning-Based Prediction of Hospital Mortality in Patients With Postoperative Sepsis.

作者信息

Yao Ren-Qi, Jin Xin, Wang Guo-Wei, Yu Yue, Wu Guo-Sheng, Zhu Yi-Bing, Li Lin, Li Yu-Xuan, Zhao Peng-Yue, Zhu Sheng-Yu, Xia Zhao-Fan, Ren Chao, Yao Yong-Ming

机构信息

Trauma Research Center, Fourth Medical Center of the Chinese PLA General Hospital, Beijing, China.

Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai, China.

出版信息

Front Med (Lausanne). 2020 Aug 11;7:445. doi: 10.3389/fmed.2020.00445. eCollection 2020.


DOI:10.3389/fmed.2020.00445
PMID:32903618
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7438711/
Abstract

The incidence of postoperative sepsis is continually increased, while few studies have specifically focused on the risk factors and clinical outcomes associated with the development of sepsis after surgical procedures. The present study aimed to develop a mathematical model for predicting the in-hospital mortality among patients with postoperative sepsis. Surgical patients in Medical Information Mart for Intensive Care (MIMIC-III) database who simultaneously fulfilled Sepsis 3.0 and Agency for Healthcare Research and Quality (AHRQ) criteria at ICU admission were incorporated. We employed both extreme gradient boosting (XGBoost) and stepwise logistic regression model to predict the in-hospital mortality among patients with postoperative sepsis. Consequently, the model performance was assessed from the angles of discrimination and calibration. We included 3,713 patients who fulfilled our inclusion criteria, in which 397 (10.7%) patients died during hospitalization, and 3,316 (89.3%) patients survived through discharge. Fluid-electrolyte disturbance, coagulopathy, renal replacement therapy (RRT), urine output, and cardiovascular surgery were important features related to the in-hospital mortality. The XGBoost model had a better performance in both discriminatory ability (c-statistics, 0.835 vs. 0.737 and 0.621, respectively; AUPRC, 0.418 vs. 0.280 and 0.237, respectively) and goodness of fit (visualized by calibration curve) compared to the stepwise logistic regression model and baseline model. XGBoost model has a better performance in predicting hospital mortality among patients with postoperative sepsis in comparison to the stepwise logistic regression model. Machine learning-based algorithm might have significant application in the development of early warning system for septic patients following major operations.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5a7/7438711/9c483ba3fd2c/fmed-07-00445-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5a7/7438711/d4fd78896fa7/fmed-07-00445-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5a7/7438711/d89698c4e08b/fmed-07-00445-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5a7/7438711/11e3d61aaa49/fmed-07-00445-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5a7/7438711/9c483ba3fd2c/fmed-07-00445-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5a7/7438711/d4fd78896fa7/fmed-07-00445-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5a7/7438711/d89698c4e08b/fmed-07-00445-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5a7/7438711/11e3d61aaa49/fmed-07-00445-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5a7/7438711/9c483ba3fd2c/fmed-07-00445-g0004.jpg

相似文献

[1]
A Machine Learning-Based Prediction of Hospital Mortality in Patients With Postoperative Sepsis.

Front Med (Lausanne). 2020-8-11

[2]
Development and validation of a novel blending machine learning model for hospital mortality prediction in ICU patients with Sepsis.

BioData Min. 2021-8-16

[3]
[Comparison of machine learning and Logistic regression model in predicting acute kidney injury after cardiac surgery: data analysis based on MIMIC-III database].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2022-11

[4]
Interpretable machine learning model for early prediction of 28-day mortality in ICU patients with sepsis-induced coagulopathy: development and validation.

Eur J Med Res. 2024-1-3

[5]
Predicting sepsis in-hospital mortality with machine learning: a multi-center study using clinical and inflammatory biomarkers.

Eur J Med Res. 2024-3-6

[6]
[Construction of a predictive model for in-hospital mortality of sepsis patients in intensive care unit based on machine learning].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2023-7

[7]
Interpretable Machine Learning to Optimize Early In-Hospital Mortality Prediction for Elderly Patients with Sepsis: A Discovery Study.

Comput Math Methods Med. 2022

[8]
Prediction model of in-hospital mortality in intensive care unit patients with cardiac arrest: a retrospective analysis of MIMIC -IV database based on machine learning.

BMC Anesthesiol. 2023-5-25

[9]
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JMIR Form Res. 2023-3-31

[10]
Prediction model of in-hospital mortality in intensive care unit patients with heart failure: machine learning-based, retrospective analysis of the MIMIC-III database.

BMJ Open. 2021-7-23

引用本文的文献

[1]
Postoperative sepsis-associated neurocognitive disorder: mechanisms, predictive strategies, and treatment approaches.

Front Med (Lausanne). 2025-6-3

[2]
Predicting Agitation-Sedation Levels in Intensive Care Unit Patients: Development of an Ensemble Model.

JMIR Med Inform. 2025-2-26

[3]
Construction and verification of a nomogram model for the risk of death in sepsis patients.

Sci Rep. 2025-2-11

[4]
An interpretable machine learning model for predicting in-hospital mortality in ICU patients with ventilator-associated pneumonia.

PLoS One. 2025-1-7

[5]
A machine learning-based prediction of hospital mortality in mechanically ventilated ICU patients.

PLoS One. 2024

[6]
Comparative Analysis of Machine Learning Models for Prediction of Acute Liver Injury in Sepsis Patients.

J Emerg Trauma Shock. 2024

[7]
Predicting sepsis in-hospital mortality with machine learning: a multi-center study using clinical and inflammatory biomarkers.

Eur J Med Res. 2024-3-6

[8]
A predictive model for postoperative adverse outcomes following surgical treatment of acute type A aortic dissection based on machine learning.

J Clin Hypertens (Greenwich). 2024-3

[9]
Early Prediction of Mortality for Septic Patients Visiting Emergency Room Based on Explainable Machine Learning: A Real-World Multicenter Study.

J Korean Med Sci. 2024-2-5

[10]
A nomogram for predicting mortality risk within 30 days in sepsis patients admitted in the emergency department: A retrospective analysis.

PLoS One. 2024-1-25

本文引用的文献

[1]
Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study.

Lancet. 2020-1-18

[2]
Predictive Utility of a Machine Learning Algorithm in Estimating Mortality Risk in Cardiac Surgery.

Ann Thorac Surg. 2019-11-7

[3]
Predictive analytics with gradient boosting in clinical medicine.

Ann Transl Med. 2019-4

[4]
Effect of a Recombinant Human Soluble Thrombomodulin on Mortality in Patients With Sepsis-Associated Coagulopathy: The SCARLET Randomized Clinical Trial.

JAMA. 2019-5-28

[5]
Machine learning for the prediction of volume responsiveness in patients with oliguric acute kidney injury in critical care.

Crit Care. 2019-4-8

[6]
Risk Factors for Post-Operative Sepsis and Septic Shock in Patients Undergoing Emergency Surgery.

Surg Infect (Larchmt). 2019-4-5

[7]
Simulation in Neurocritical Care: Past, Present, and Future.

Neurocrit Care. 2019-6

[8]
Hospital variability of postoperative sepsis and sepsis-related mortality after elective coronary artery bypass grafting surgery.

J Crit Care. 2018-7-17

[9]
[Point-of-care Coagulation Testing in Neurosurgery].

Anasthesiol Intensivmed Notfallmed Schmerzther. 2018-6

[10]
Sepsis and septic shock.

Lancet. 2018-6-21

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