Early Prediction of Sepsis in EMR Records Using Traditional ML Techniques and Deep Learning LSTM Networks

Sepsis is a life-threatening condition caused by infection and subsequent overreaction by the immune system. Physicians effectively treat sepsis with early administration of antibiotics. However, excessive use of antibiotics on false positive cases cultivates antibiotic resistant bacterial strains and can waste resources while false negative cases result in unacceptable mortality rates. Accurate early prediction ensures correct, early antibiotic treatment; unfortunately, prediction remains daunting due to error-ridden electronic medical records (EMRs) and the inherent complexity of sepsis. We aimed to predict sepsis using only the first 24 and 36 hours of lab results and vital signs for a patient. We used the Medical Information Mart for Intensive Care III (MIMIC3) dataset to test machine learning (ML) techniques including traditional methods (i.e., random forest (RF) and logistic regression (LR)) as well as deep learning techniques (i.e., long short-term memory (LSTM) neural networks). We successfully created a data pipeline to process and clean data, identified important predictive features using RF and LR techniques, and trained LSTM networks. We found that our best performing traditional classifier, RF, had an Area Under the Curve (AUC-ROC) score of 0.696, and our LSTM networks did not outperform RF.

[1]  Hye Jin Kam,et al.  Learning representations for the early detection of sepsis with deep neural networks , 2017, Comput. Biol. Medicine.

[2]  T. Dorman,et al.  Surviving Sepsis Guidelines: A Continuous Move Toward Better Care of Patients With Sepsis. , 2017, JAMA.

[3]  G. Escobar,et al.  The Timing of Early Antibiotics and Hospital Mortality in Sepsis , 2017, American journal of respiratory and critical care medicine.

[4]  M. Levin,et al.  Microbiological outcomes and antibiotic overuse in Emergency Department patients with suspected sepsis. , 2017, The Netherlands journal of medicine.

[5]  T. O'Shea,et al.  Heart rate characteristics: physiomarkers for detection of late-onset neonatal sepsis. , 2010, Clinics in perinatology.

[6]  C. Moore,et al.  Predictive models for severe sepsis in adult ICU patients , 2015, 2015 Systems and Information Engineering Design Symposium.

[7]  J. Vincent,et al.  Sepsis biomarkers: a review , 2010, Critical care.

[8]  William Fleischman,et al.  Prediction of In-hospital Mortality in Emergency Department Patients With Sepsis: A Local Big Data-Driven, Machine Learning Approach. , 2016, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[9]  Pritpal S Tamber,et al.  The Surviving Sepsis Campaign: raising awareness to reduce mortality , 2003, Critical care.

[10]  Aram Galstyan,et al.  Multitask learning and benchmarking with clinical time series data , 2017, Scientific Data.

[11]  F. Lupu “Crossroads in Sepsis Research” Review Series Overview of the pathophysiology of sepsis , 2008, Journal of cellular and molecular medicine.

[12]  May D. Wang,et al.  –Omic and Electronic Health Record Big Data Analytics for Precision Medicine , 2017, IEEE Transactions on Biomedical Engineering.

[13]  Lauren E Marsillio,et al.  A Review of Biomarkers and Physiomarkers in Pediatric Sepsis , 2014 .

[14]  Theodore J Iwashyna,et al.  Identifying Patients With Severe Sepsis Using Administrative Claims: Patient-Level Validation of the Angus Implementation of the International Consensus Conference Definition of Severe Sepsis , 2014, Medical care.

[15]  Adil Rafiq Rather,et al.  The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) , 2015 .

[16]  Peter Szolovits,et al.  MIMIC-III, a freely accessible critical care database , 2016, Scientific Data.