Al-Ansari Aisha A, Nejad Fatima A Bahman, Al-Nasr Roudha J, Prithula Johayra, Rahman Tawsifur, Hasan Anwarul, Chowdhury Muhammad E H, Alam Mohammed Fasihul
Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar.
Department of Electrical and Electronics Engineering, University of Dhaka, Dhaka 1000, Bangladesh.
J Clin Med. 2025 May 16;14(10):3495. doi: 10.3390/jcm14103495.
: Sepsis leads to substantial global health burdens in terms of morbidity and mortality and is associated with numerous risk factors. It is crucial to identify sepsis at an early stage in order to limit its escalation and sequelae associated with the condition. The purpose of this research is to predict ICU mortality early and evaluate the predictive accuracy of machine learning algorithms for ICU mortality among septic patients. : The study used a retrospective cohort from computerized ICU records accumulated from 280 hospitals between 2014 and 2015. Initially the sample size was 23.47K. Several machine learning models were trained, validated, and tested using five-fold cross-validation, and three sampling strategies (Under-Sampling, Over-Sampling, and Combination). : The under-sampled approach combined with augmentation for the Extra Trees model produced the best performance with Accuracy, Precision, Sensitivity, Specificity, F1-Score, and AUC of 90.99%, 84.16%, 94.89%, 88.48%, 89.20%, and 91.69%, respectively, with Top 30 features. For Over-Sampling, the Top 29 combined features showed the best performance with Accuracy, Precision, Sensitivity, Specificity, F1-Score, and AUC of 82.99%, 51.38%, 71.72%, 85.41%, 59.87%, and 78.56%, respectively. For Down-Sampling, the Top 31 combined features produced Accuracy, Precision, Sensitivity, Specificity, F1-Score, and AUC of 81.78%, 49.08%, 79.76%, 82.21%, 60.76%, and 80.98%, respectively. : Machine learning models can reliably predict ICU mortality when suitable clinical predictors are utilized. The study showed that the proposed Extra Trees model can predict ICU mortality with an accuracy of 90.99% accuracy using only single-entry data. Incorporating longitudinal data could further enhance model performance.
脓毒症在发病率和死亡率方面给全球带来了沉重的健康负担,且与众多风险因素相关。早期识别脓毒症对于限制其病情进展及相关后遗症至关重要。本研究的目的是早期预测重症监护病房(ICU)死亡率,并评估机器学习算法对脓毒症患者ICU死亡率的预测准确性。
该研究使用了一个回顾性队列,数据来自2014年至2015年期间280家医院积累的计算机化ICU记录。最初样本量为23470例。使用五折交叉验证以及三种抽样策略(欠抽样、过抽样和组合抽样)对多个机器学习模型进行了训练、验证和测试。
欠抽样方法与Extra Trees模型的增强技术相结合,在使用前30个特征时,准确率、精确率、灵敏度、特异性、F1分数和曲线下面积(AUC)分别达到90.99%、84.16%、94.89%、88.48%、89.20%和91.69%,表现最佳。对于过抽样,前29个组合特征表现最佳,准确率、精确率、灵敏度、特异性、F1分数和AUC分别为82.99%、51.38%、71.72%、85.41%、59.87%和78.56%。对于下采样,前31个组合特征的准确率、精确率、灵敏度、特异性、F1分数和AUC分别为81.78%、49.08%、79.76%、82.21%、60.76%和80.98%。
当使用合适的临床预测指标时,机器学习模型能够可靠地预测ICU死亡率。研究表明,所提出的Extra Trees模型仅使用单条目数据就能以90.99%的准确率预测ICU死亡率。纳入纵向数据可进一步提高模型性能。