Assessment of a Combined Biomarker-EMR Data Machine Learning Model for Sepsis-3
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Sepsis, Pharmacology, 2022
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INTRODUCTION: Early administration of broad-spectrum antibiotics for patients at high risk of sepsis leads to reduced morbidity and mortality. However, timely broad-spectrum administration for these patients is often challenging due to the lack of information available to rapidly and accurately identify patients at high risk of sepsis. In this work, the diagnostic and prognostic capabilities of a machine learning model (MLM) that predicts the risk of sepsis within 12 hours after the first blood culture order (BCO), is explored. METHODOLOGY: Adult patients suspected of sepsis in an emergency department or hospital, as defined by a BCO were recruited from three U.S. hospitals (Nf2398). IL-6, PCT, and CRP measurements were measured from discards of samples drawn +/-3 hours from the first BCO using a magnetic bead assay. 23 other clinical features (results of a Complete Blood Count, a Complete Metabolic panel, vitals, and demographic information) were extracted from the Electronic Medical Records. A random forest model was trained (Nf1918) to provide a sepsis risk score and a prognostic risk category (low, medium, or high). Diagnostic performance for the MLM’s ability to predict a Sepsis-3 event within 12 hours of the BCO was quantified and compared to PCT and CRP in a test cohort (N = 480). The utility of the prognostic risk categories was explored by examining the differences in Length of Stay (LOS), 30-day-mortality, 30-day-readmission, and time to ICU transfer in the Test Cohort. RESULTS: The MLM exhibited an Area Under the Receiver Operating Curve (AUROC) of 0.87 compared to an AUROC of 0.765 and 0.581 for PCT and CRP, respectively. The MLM showed separability among the prognostic risk groups for LOS (p < 0.001), 30-day-mortality (p < 0.001), and time to ICU transfer (p < 0.0001), and 30-day-readmission (p = 0.018). CONCLUSION: In this work, a MLM which integrates 3 sepsis biomarkers (IL-6, PCT, and CRP) with 23 other routinely measured clinical parameters was shown to have excellent diagnostic performance and prognostic utility. Such a tool could help physicians quickly and accurately determine which patients should be prioritized for rapid administration of broad-spectrum antibiotics in hospital and emergency department environments.
Meta Tag
Content Type Presentation
Knowledge Area Sepsis
Knowledge Area Pharmacology
Knowledge Level Advanced
Learning Pathway Sepsis Resources
Membership Level Select
Tag Sepsis
Tag Antibiotics
Year 2022
sepsis immunoscore
biomarker data
early diagnosis
treatment decisions
diagnostic performance
Sepsis Resources


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