Artificial intelligence in critical care: prediction of sepsis in patients in intensive care from first initial laboratory parameters

Abstract

Background: Sepsis is a leading cause of morbidity and mortality in the critical care setting. The analysis of hemostatic parameters at admission have been proven to be a predictive marker for development of sepsis in the ICU. The present study aims to develop a machine learning model which can predict the development of sepsis after 72 hours of ICU admission, from initial assessment of hemostatic parameters. Methods: A total of 170 ICU admissions over six months (May 2018 -Dec 2018) period were included in the study. Hemostatic parameters including platelet counts, prothrombin time and Sonoclot assay were assayed at time of admission. The patients were followed up for development of sepsis. The data was split in two sets: training (100) and test (70). A machine learning model was developed using the linear discriminant analysis (LDA) model, in the R programming environment. The statistical parameters employed were sensitivity, specificity, positive and negative predictive value. Results: A comparison of incidence of development of clinical sepsis and predicted sepsis by the model showed 74.19% sensitivity and 84.61% specificity over the testing set. 06 false positives and 08 false negative predictions were encountered. Conclusions: The model shows potential to be used as a predictive tool for development of sepsis in the critical care ward. Moderate sensitivity and good specificity were achieved by the model, highlighting the role of hematologic assessment at admission in prediction of development of sepsis. However, further studies with larger datasets are required before implementation in clinical practice.