Establishment and validation of the predictive model for the in-hospital death in patients with sepsis - 18/11/21
Highlight |
• | Models to predict in-hospital death of sepsis patients were established. |
• | The random forest model had the better predictive ability. |
• | The model fit was good in the external population with SOFA score of 13-15. |
Abstract |
Background |
Identifying sepsis patients with risk of in-hospital death early can improve the prognosis of patients. This study aimed to develop a model to predict in-hospital death of sepsis patients based on the Medical Information Mart for Intensive Care-Ⅲ (MIMIC-Ⅲ) database, and use clinical data to externally validate the model.
Methods |
A total of 1,839 sepsis patients were used for model development, and 125 clinical cases were used for external validation. The discriminatory ability of the model was determined by calculating the area under the curve (AUC) with 95% confidence intervals (CI).
Results |
The AUC of the random forest model and logistic regression model was 0.754 (95%CI, 0.732-0.776) and 0.703 (95%CI, 0.680-0.727), respectively, and the random forest model had higher AUC (Z = 3.070, P = .002). External validation showed that the AUC of the random forest model was 0.539 (95%CI, 0.440-0.628). Further validation was carried out according to gender and SOFA score. The AUC of the model in males and females was 0.648 and 0.412, respectively. In addition, the AUC of the model in the population with SOFA scores of 3-8, 9-12, and 13-15 were 0.705, 0.495, and 0.769, respectively.
Conclusions |
The random forest model had a better predictive ability and a good applicability to external populations with SOFA score of 13-15.
Le texte complet de cet article est disponible en PDF.Key Words : Prediction, Random forest model, MIMIC-III, SOFA
Plan
| Funding: This study was supported by the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding (number: ZYLX201802). |
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| Conflicts of Interests: None. |
Vol 49 - N° 12
P. 1515-1521 - décembre 2021 Retour au numéro
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