Developing a rapid screening tool for high-risk ICU patients of sepsis: integrating electronic medical records with machine learning methods for mortality prediction in hospitalized patients-model establishment, internal and external validation, and visualization

开发一种针对重症监护室高危脓毒症患者的快速筛查工具:将电子病历与机器学习方法相结合,用于预测住院患者的死亡率——模型建立、内部和外部验证以及可视化

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Abstract

OBJECTIVES: To develop a machine learning-based prediction model using clinical data from the first 24 h of ICU admission to enable rapid screening and early intervention for sepsis patients. METHODS: This multicenter retrospective cohort study analyzed electronic medical records of sepsis patients using machine learning methods. We evaluated model performance in predicting sepsis outcomes within the first 24 h of ICU admission across US and Chinese healthcare settings. RESULTS: From 31 clinical features, machine learning models demonstrated significantly better predictive performance than traditional approaches for sepsis outcomes. While linear regression achieved low test scores (0.25), machine learning methods reached scores of 0.78 and AUCs above 0.8 in testing. Importantly, these models maintained robust performance (scores 0.63-0.77) in external validation. CONCLUSIONS: The application of machine learning-based prediction models for sepsis could significantly improve patient outcomes through early detection and timely intervention in the critical first 24 h of ICU admission, supporting clinical decision-making.

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