Imputation-Enhanced Prediction of Septic Shock in ICU Patients

Sepsis and septic shock are potentially fatal complications that frequently occur in intensive care unit patients. The ability to predict which patients are at risk for sepsis and septic shock is therefore crucial to limiting the eects of these complications. Potential indications for sepsis risk are scattered in a wide range of clinical measurements, including high-temporal resolution physiological waveforms, Xrays and gene expression levels, etc., leading to a non-trivial prediction problem. Thus previous works on sepsis prediction have used very small, carefully curated datasets, with limited applicability. Recently however, a large, rich ICU dataset called MIMIC-II has been made publicly available, providing opportunity for more extensive modeling of this problem. However, such a large dataset inevitably comes with a substantial higher amount of missing data. In this paper, we investigate how dierent imputation methods can overcome the handicap of missing information while leveraging such a large dataset. Our results show that imputation approaches in conjunction with predictive modeling lead to a decent boost in accuracy of sepsis risk prediction and a huge improvement in prediction of septic shock, even when one is restricted to only using non-invasive measurements. Our models can be applied to any ICU patient and lead to a generalized approach for predicting sepsis related complications.

[1]  Michael I. Jordan,et al.  Advances in Neural Information Processing Systems 30 , 1995 .

[2]  W. Knaus,et al.  Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. , 1992, Chest.

[3]  Sam T. Roweis,et al.  EM Algorithms for PCA and SPCA , 1997, NIPS.

[4]  E Peterson,et al.  Early goal-directed therapy in the treatment of severe sepsis and septic shock. , 2018, The New England journal of medicine.

[5]  Russ B. Altman,et al.  Missing value estimation methods for DNA microarrays , 2001, Bioinform..

[6]  S. Dzik Early goal-directed therapy in the treatment of severe sepsis and septic shock , 2002 .

[7]  Jürgen Paetz Knowledge-based approach to septic shock patient data using a neural network with trapezoidal activation functions , 2003, Artif. Intell. Medicine.

[8]  Shin Ishii,et al.  A Bayesian missing value estimation method for gene expression profile data , 2003, Bioinform..

[9]  Joachim Selbig,et al.  pcaMethods - a bioconductor package providing PCA methods for incomplete data , 2007, Bioinform..

[10]  Dewang Shavdia,et al.  Septic shock : providing early warnings through multivariate logistic regression models , 2007 .

[11]  M. J. Pearce,et al.  Presymptomatic Prediction of Sepsis in Intensive Care Unit Patients , 2008, Clinical and Vaccine Immunology.

[12]  Femida Gwadry-Sridhar,et al.  Comparison of Analytic Approaches for Determining Variables - A Case Study in Predicting the Likelihood of Sepsis , 2009, HEALTHINF.

[13]  Nigel H Lovell,et al.  Non-invasive classification of severe sepsis and systemic inflammatory response syndrome using a nonlinear support vector machine: a preliminary study , 2010, Physiological measurement.

[14]  Joshua A. Doherty,et al.  Early prediction of septic shock in hospitalized patients. , 2010, Journal of hospital medicine.

[15]  João Miguel da Costa Sousa,et al.  Predicting Outcomes of Septic Shock Patients Using Feature Selection Based on Soft Computing Techniques , 2010, IPMU.

[16]  Uzay Kaymak,et al.  Predicting septic shock outcomes in a database with missing data using fuzzy modeling: Influence of pre-processing techniques on real-world data-based classification , 2011, 2011 IEEE International Conference on Fuzzy Systems (FUZZ-IEEE 2011).

[17]  T. H. Kyaw,et al.  Multiparameter Intelligent Monitoring in Intensive Care II: A public-access intensive care unit database* , 2011, Critical care medicine.

[18]  M. Saeed Multiparameter Intelligent Monitoring in Intensive Care II ( MIMIC-II ) : A public-access intensive care unit database , 2011 .