Development and Validation of Deep-Learning-Based Sepsis and Septic Shock Early Prediction System (DeepSEPS) Using Real-World ICU Data

Author:

Kim Taehwa1ORCID,Tae Yunwon2ORCID,Yeo Hye Ju13ORCID,Jang Jin Ho1ORCID,Cho Kyungjae2,Yoo Dongjoon24ORCID,Lee Yeha2,Ahn Sung-Ho5,Kim Younga6ORCID,Lee Narae6ORCID,Cho Woo Hyun13

Affiliation:

1. Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Pusan National University and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea

2. VUNO, Seoul 06541, Republic of Korea

3. Department of Internal Medicine, School of Medicine, Pusan National University, Busan 46241, Republic of Korea

4. Department of Critical Care Medicine and Emergency Medicine, Inha University College of Medicine, Incheon 22212, Republic of Korea

5. Division of Biostatistics, Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea

6. Department of Pediatrics, School of Medicine, Pusan National University, Yangsan 50612, Republic of Korea

Abstract

Background: Successful sepsis treatment depends on early diagnosis. We aimed to develop and validate a system to predict sepsis and septic shock in real time using deep learning. Methods: Clinical data were retrospectively collected from electronic medical records (EMRs). Data from 2010 to 2019 were used as development data, and data from 2020 to 2021 were used as validation data. The collected EMRs consisted of eight vital signs, 13 laboratory data points, and three demographic information items. We validated the deep-learning-based sepsis and septic shock early prediction system (DeepSEPS) using the validation datasets and compared our system with other traditional early warning scoring systems, such as the national early warning score, sequential organ failure assessment (SOFA), and quick sequential organ failure assessment. Results: DeepSEPS achieved even higher area under receiver operating characteristic curve (AUROC) values (0.7888 and 0.8494 for sepsis and septic shock, respectively) than SOFA. The prediction performance of traditional scoring systems was enhanced because the early prediction time point was close to the onset time of sepsis; however, the DeepSEPS scoring system consistently outperformed all conventional scoring systems at all time points. Furthermore, at the time of onset of sepsis and septic shock, DeepSEPS showed the highest AUROC (0.9346). Conclusions: The sepsis and septic shock early warning system developed in this study exhibited a performance that is worth considering when predicting sepsis and septic shock compared to other traditional early warning scoring systems. DeepSEPS showed better performance than existing sepsis prediction programs. This novel real-time system that simultaneously predicts sepsis and septic shock requires further validation.

Funder

Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea

Publisher

MDPI AG

Subject

General Medicine

Reference48 articles.

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3. Vincent, J.L. (2016). The clinical challenge of sepsis identification and monitoring. PLoS Med., 13.

4. Assessment of Health Care Exposures and Outcomes in Adult Patients with Sepsis and Septic Shock;Fay;JAMA Netw. Open,2020

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