Department of Pediatrics, NYU Grossman School of Medicine, New York.
Department of Emergency Medicine, NYU Grossman School of Medicine, New York.
AMIA Annu Symp Proc. 2022 Feb 21;2021:1129-1138. eCollection 2021.
Pediatric sepsis imposes a significant burden of morbidity and mortality among children. While the speedy application of existing supportive care measures can substantially improve outcomes, further improvements in delivering that care require tools that go beyond recognizing sepsis and towards predicting its development. Machine learning techniques have great potential as predictive tools, but their application to pediatric sepsis has been stymied by several factors, particularly the relative rarity of its occurrence. We propose an alternate approach which focuses on predicting the provision of resuscitative care, rather than sepsis diagnoses or criteria themselves. Using three years of Emergency Department data from a large academic medical center, we developed a boosted tree model that predicts resuscitation within 6 hours of triage, and significantly outperforms existing rule-based sepsis alerts.
儿科脓毒症给儿童带来了重大的发病和死亡负担。虽然迅速应用现有的支持性护理措施可以显著改善预后,但要进一步提高护理质量,就需要超越识别脓毒症并预测其发展的工具。机器学习技术具有成为预测工具的巨大潜力,但由于多种因素,它们在儿科脓毒症中的应用受到了阻碍,特别是该病症相对罕见。我们提出了一种替代方法,该方法侧重于预测复苏治疗的提供,而不是脓毒症的诊断或标准本身。我们使用来自一家大型学术医疗中心的三年急诊数据,开发了一个增强树模型,可预测分诊后 6 小时内的复苏,并显著优于现有的基于规则的脓毒症警报。