Utilizing machine learning to create a blood-based scoring system for sepsis detection
DOI:
https://doi.org/10.15584/ejcem.2023.4.27Keywords:
blood-based, machine learning, sepsisAbstract
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.
Downloads
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
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 European Journal of Clinical and Experimental Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.
Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself.
All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.




