Machine learning models for predicting in-hospital mortality in patient with sepsis: Analysis of vital sign dynamics.

Abstract

To build machine learning models for predicting the risk of in-hospital death in patients with sepsis within 48 h, using only dynamic changes in the patient's vital signs. This retrospective observational cohort study enrolled septic patients from five emergency departments (ED) in Taiwan. We adopted seven variables, i.e., age, sex, systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, and body temperature. Among all 353,253 visits, after excluding 159,607 visits (45%), the study group consisted of 193,646 ED visits. With a leading time of 6 h, the convolutional neural networks (CNNs), long short-term memory (LSTM), and random forest (RF) had accuracy rates of 0.905, 0.817, and 0.835, respectively, and the area under the receiver operating characteristic curve (AUC) was 0.840, 0.761, and 0.770, respectively. With a leading time of 48 h, the CNN, LSTM, and RF achieved accuracy rates of 0.828, 0759, and 0.805, respectively, and an AUC of 0.811, 0.734, and 0.776, respectively. By analyzing dynamic vital sign data, machine learning models can predict mortality in septic patients within 6 to 48 h of admission. The performance of the testing models is more accurate if the lead time is closer to the event.