DOI: 10.1101/457465Oct 30, 2018Paper

Effect of a Sepsis Prediction Algorithm on Patient Mortality, Length of Stay, and Readmission

BioRxiv : the Preprint Server for Biology
Hoyt BurdickRitankar Das

Abstract

Objective: To validate performance of a machine learning algorithm for severe sepsis determination up to 48 hours before onset, and to evaluate the effect of the algorithm on in-hospital mortality, hospital length of stay, and 30-day readmission. Setting: This cohort study includes a combined retrospective analysis and clinical outcomes evaluation: a dataset containing 510,497 patient encounters from 461 United States health centers for retrospective analysis, and a multiyear, multicenter clinical data set of real-world data containing 75,147 patient encounters from nine hospitals for clinical outcomes evaluation. Participants: For retrospective analysis, 270,438 adult patients with at least one documented measurement of five out of six vital sign measurements were included. For clinical outcomes analysis, 17,758 adult patients who met two or more Systemic Inflammatory Response Syndrome (SIRS) criteria at any point during their stay were included. Results: At severe sepsis onset, the MLA demonstrated an AUROC of 0.91 (95% CI 0.90, 0.92), which exceeded those of MEWS (0.71, P<.001), SOFA (0.74; P<.001), and SIRS (0.62; P<.001). For severe sepsis prediction 48 hours in advance of onset, the MLA achieved an AUROC of 0.77 (95% CI 0...Continue Reading

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