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人工智能在脓毒症诊断和预后评估中的潜力:一项叙述性综述

The Potential of Artificial Intelligence in the Diagnosis and Prognosis of Sepsis: A Narrative Review.

作者信息

Țocu George, Lisă Elena Lăcrămioara, Tutunaru Dana, Mihailov Raul, Șerban Cristina, Luțenco Valerii, Dimofte Florentin, Guliciuc Mădălin, Chiscop Iulia, Ștefănescu Bogdan Ioan, Niculeț Elena, Gurău Gabriela, Berbece Sorin Ion, Mihailov Oana Mariana, Stavăr Matei Loredana

机构信息

Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, 800008 Galati, Romania.

Department of Clinical Surgery, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, 800008 Galati, Romania.

出版信息

Diagnostics (Basel). 2025 Aug 27;15(17):2169. doi: 10.3390/diagnostics15172169.

Abstract

Sepsis is a severe medical condition characterized by a dysregulated host response to infection, with potentially fatal outcomes, requiring early diagnosis and rapid intervention. The limitations of traditional sepsis identification methods, as well as the complexity of clinical data generated in intensive care, have driven increased interest in applying artificial intelligence in this field. The aim of this narrative review article is to analyze how artificial intelligence is being used in the diagnosis and prognosis of sepsis, to present the most relevant current models and algorithms, and to discuss the challenges and opportunities related to integrating these technologies into clinical practice. We conducted a structured literature search for this narrative review, covering studies published between 2016 and 2024 in databases such as PubMed/Medline, Scopus, Web of Science, IEEE Xplore, and Google Scholar. The review covered models based on machine learning (ML), deep neural networks (DNNs), Recurrent Neural Networks (RNNs), and clinical alert systems implemented in hospitals. The clinical data sources used, algorithms applied, system architectures, and performance outcomes are presented. Numerous artificial intelligence models demonstrated superior performance compared to conventional clinical scores (qSOFA, SIRS), achieving AUC values above 0.90 in predicting sepsis and mortality. Systems such as Targeted Real-Time Early Warning System (TREWS) and InSight have been clinically validated and have significantly reduced the time to treatment initiation. However, challenges remain, such as a lack of model transparency, algorithmic bias, difficulties integrating into clinical workflows, and the absence of external validation in multicenter settings. Artificial intelligence has the potential to transform sepsis management through early diagnosis, risk stratification, and personalized treatment. A responsible, multidisciplinary approach is necessary, including rigorous clinical validation, enhanced interpretability, and training of healthcare personnel to effectively integrate these technologies into everyday practice.

摘要

脓毒症是一种严重的医学病症,其特征是宿主对感染的反应失调,可能导致致命后果,需要早期诊断和快速干预。传统脓毒症识别方法的局限性以及重症监护中产生的临床数据的复杂性,促使人们对在该领域应用人工智能的兴趣日益增加。这篇叙述性综述文章的目的是分析人工智能如何用于脓毒症的诊断和预后,介绍当前最相关的模型和算法,并讨论将这些技术整合到临床实践中所面临的挑战和机遇。我们为这篇叙述性综述进行了结构化文献检索,涵盖了2016年至2024年期间在PubMed/Medline、Scopus、Web of Science、IEEE Xplore和谷歌学术等数据库中发表的研究。该综述涵盖了基于机器学习(ML)、深度神经网络(DNN)、循环神经网络(RNN)的模型以及医院实施的临床警报系统。文中呈现了所使用的临床数据源、应用的算法、系统架构和性能结果。与传统临床评分(qSOFA、SIRS)相比,众多人工智能模型表现出卓越性能,在预测脓毒症和死亡率方面的AUC值高于0.90。诸如靶向实时早期预警系统(TREWS)和洞察系统(InSight)等系统已通过临床验证,并显著缩短了开始治疗的时间。然而,挑战依然存在,例如缺乏模型透明度、算法偏差、难以融入临床工作流程以及在多中心环境中缺乏外部验证。人工智能有潜力通过早期诊断、风险分层和个性化治疗来改变脓毒症的管理。需要采取一种负责任的多学科方法,包括严格的临床验证、增强的可解释性以及对医护人员的培训,以有效地将这些技术融入日常实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fcd/12427803/ac72e26c96bc/diagnostics-15-02169-g001.jpg

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