Utilizing machine learning to create a blood-based scoring system for sepsis detection

Authors

DOI:

https://doi.org/10.15584/ejcem.2023.4.27

Keywords:

blood-based, machine learning, sepsis

Abstract

Introduction and aim. Sepsis, a disease caused by inflammation as a response to infection, often goes undiagnosed due to its heterogeneity and lack of a single diagnostic test. Current sepsis detection scoring systems have low sensitivity and utilize biomarkers that are difficult to obtain from a single test. The goal of this research is to create a scoring system that outperforms current industry standards by utilizing blood-based biomarkers readily available in hospital settings.

Material and methods. Machine learning algorithms were run through Google Colab using Extreme Gradient Boost classifier. The dataset was obtained from NCBI website containing electronic hospital records of intensive care patients. A multivariate linear regression was applied to the dataset to determine statistically significant biomarkers in the detection of sepsis, and their β coefficients. Then, validation testing was performed, and the performance was compared to other scoring systems.

Results. This experiment reveals that a sepsis detection system that utilizes procalcitonin, white blood cells, C-reactive protein, neutrophil to lymphocyte ratio, and albumin can outperform other biomarkers and scoring systems with high sensitivity at a recall score of 0.7922.

Conclusion. These results demonstrate the potential of utilizing a blood-based scoring system for sepsis detection within hospital settings.

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References

Network J. Consensus Definitions for Sepsis and Septic Shock from JAMA Network. Jamanetwork.com. https://sites.jamanetwork.com/sepsis/. Accessed March 10, 2023.

Mollura M, Lehman LW, Barbieri R. Assessment of Sepsis in the ICU by Linear and Complex Characterization of Cardiovascular Dynamics. Annu Int Conf IEEE Eng Med Biol Soc. 2021;2021:862-865. doi: 10.1109/EMBC46164.2021.9630521

Sepsis. Global Sepsis Alliance. https://www.global-sepsis-alliance.org/sepsis. Accessed March 10, 2023.

CDC. Sepsis is a medical emergency. ACT FAST. Centers for Disease Control and Prevention. http://www.cdc.gov/sepsis/what-is-sepsis.html. Accessed March 10, 2023.

Camacho-Cogollo JE, Bonet I, Gil B, Iadanza E. Machine Learning Models for Early Prediction of Sepsis on Large Healthcare Datasets. Electronics. 2022;11(9):1507. doi: 10.3390/electronics11091507

Jones AE, Trzeciak S, Kline JA. The Sequential Organ Failure Assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation. Crit Care Med. 2009;37(5):1649-1654. doi: 10.1097/ccm.0b013e31819def97

Heldwein MB, Badreldin AM, Doerr F, et al. Logistic Organ Dysfunction Score (LODS): A reliable postoperative risk management score also in cardiac surgical patients? J Cardiothorac Surg. 2011;6:110. doi: 10.1186/1749-8090-6-110

Dahhan T, Jamil M, Al-Tarifi A, Abouchala N, Kherallah M. Validation of the APACHE IV scoring system in patients with severe sepsis and comparison with the APACHE II system. Crit Care. 2009;13(Suppl 1):P511. doi: 10.1186/cc7675

Sun GD, Zhang Y, Mo SS, Zhao MY. Multiple Organ Dysfunction Syndrome Caused by Sepsis: Risk Factor Analysis. Int J Gen Med. 2021;14:7159-7164. doi: 10.2147/ijgm.s328419

Chakraborty RK, Burns B. Systemic Inflammatory Response Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 29, 2023.

Vijayan AL, Vanimaya, Ravindran S, et al. Procalcitonin: a promising diagnostic marker for sepsis and antibiotic therapy. J Intensive Care. 2017;5(1):51. doi: 10.1186/s40560-017-0246-8

Becker KL, Snider R, Nylen ES. Procalcitonin assay in systemic inflammation, infection, and sepsis: Clinical utility and limitations. Crit Care Med. 2008;36(3):941-952. doi: 10.1097/ccm.0b013e318165babb

Magrini L, Gagliano G, Travaglino F, et al. Comparison between white blood cell count, procalcitonin and C reactive protein as diagnostic and prognostic biomarkers of infection or sepsis in patients presenting to emergency department. Clin Chem Lab Med. 2014;52(10):1465-1472. doi: 10.1515/cclm-2014-0210

Li Y, Min L, Zhang X. Usefulness of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections in children. BMC Pulm Med. 2021;21(1):386. doi: 10.1186/s12890-021-01756-4

Cao Y, Su Y, Guo C, He L, Ding N. Albumin Level is Associated with Short-Term and Long-Term Outcomes in Sepsis Patients Admitted in the ICU: A Large Public Database Retrospective Research. Clin Epidemiol. 2023;15:263-273. doi: 10.2147/clep.s396247

Oh TK, Song IA, Lee JH. Clinical usefulness of C-reactive protein to albumin ratio in predicting 30-day mortality in critically ill patients: A retrospective analysis. Sci Rep. 2018;8(1):14977. doi: 10.1038/s41598-018-33361-7

Liu X, Shen Y, Wang H, Ge Q, Fei A, Pan S. Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Patients with Sepsis: A Prospective Observational Study. Mediators Inflamm. 2016;2016:1-8. doi: 10.1155/2016/8191254

Tsui TL, Huang YT, Kan WC, et al. A novel procalcitonin-based score for detecting sepsis among critically ill patients. PLOS ONE. 2021;16(1):e0245748. doi: 10.1371/journal.pone.0245748

scikit-learn: machine learning in Python — scikit-learn 1.0.2 documentation. scikit-learn.org. http://scikit-learn.org/stable/. Accessed March 20, 2023.

Angus DC, Wax RS. Epidemiology of sepsis: An update. Crit Care Med. 2001;29:S109-S116. doi: 10.1097/00003246-200107001-00035

Luo X, Wang H, Hu S, et al. Comparison of three different organ failure assessment score systems in predicting outcome of severe sepsis. Zhonghua Wai Ke Za Zhi. 2009;47(1):48-50. doi: 10.3760/cma.j.issn.0529-5815.2009.01.017

Liang P, Yu F. Value of CRP, PCT, and NLR in Prediction of Severity and Prognosis of Patients With Bloodstream Infections and Sepsis. Front Surg. 2022;9:857218. doi: 10.3389/fsurg.2022.857218

Meisner M, Tschaikowsky K, Palmaers T, Schmidt J. Comparison of procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS. Crit Care. 1999;3(1):45. doi: 10.1186/cc306

Gregoriano C, Heilmann E, Molitor A, Schuetz P. Role of procalcitonin use in the management of sepsis. J Thorac Dis. 2020;12:5-15. doi: 10.21037/jtd.2019.11.63

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Published

2023-12-30

How to Cite

Aref, S. (2023). Utilizing machine learning to create a blood-based scoring system for sepsis detection. European Journal of Clinical and Experimental Medicine, 21(4), 830–834. https://doi.org/10.15584/ejcem.2023.4.27

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ORIGINAL PAPERS