Abstract
Background: Pneumonia-associated sepsis constitutes a significant portion of all sepsis cases and is a leading cause of sepsis-related morbidity and mortality. The clinical burden is especially pronounced in general ward settings, where delayed recognition can hinder timely intervention. This underscores the necessity for advanced tools that facilitate early detection. Methods: This retrospective, single-center study assessed an AI-driven deep learning model designed to predict in-hospital sepsis up to four hours in advance. We analyzed 7715 pneumonia cases identified through chest radiography or CT. The model's performance was evaluated using AUROC, sensitivity, specificity, and lead time to sepsis onset and was compared against established scoring systems: NEWS, MEWS, SOFA, and qSOFA. Sepsis was defined according to the CDC Adult Sepsis Event criteria in alignment with Sepsis-3 guidelines. Results: The AI model exhibited strong performance in the early detection of sepsis among pneumonia patients, achieving an AUROC of 0.870, with a sensitivity of 76.7% and specificity of 84.1%. It significantly surpassed conventional scoring systems: NEWS (0.697), MEWS (0.661), SOFA (0.649), and qSOFA (0.678). Importantly, the model identified sepsis a median of 183 min earlier than recognition based on the operational definition. This lead-time advantage was consistent in the pneumonia cohort, where 18.3% of patients developed sepsis. Conclusions: The AI model demonstrated strong predictive capabilities for pneumonia-associated sepsis, facilitating earlier clinical decision-making. Integrating this model into EMR systems could be an effective strategy to enhance sepsis outcomes in general ward settings. Further prospective studies are needed to validate its effectiveness in real-time clinical applications.