Background: Identifying sepsis patients with risk of in-hospital death early can improve the prognosis of patients. This study aimed to develop a model to predict in-hospital death of sepsis patients based on the Medical Information Mart for Intensive Care-III (MIMIC-III) database, and use clinical data to externally validate the model. Methods: A total of 1,839 sepsis patients were used for model development, and 125 clinical cases were used for external validation. The discriminatory ability of the model was determined by calculating the area under the curve (AUC) with 95% confidence intervals (CI). Results: The AUC of the random forest model and logistic regression model was 0.754 (95%CI, 0.732-0.776) and 0.703 (95%CI, 0.680-0.727), respectively, and the random forest model had higher AUC (Z = 3.070, P = .002). External validation showed that the AUC of the random forest model was 0.539 (95%CI, 0.4400.628). Further validation was carried out according to gender and SOFA score. The AUC of the model in males and females was 0.648 and 0.412, respectively. In addition, the AUC of the model in the population with SOFA scores of 3-8, 9-12, and 13-15 were 0.705, 0.495, and 0.769, respectively. Conclusions: The random forest model had a better predictive ability and a good applicability to external populations with SOFA score of 13-15. (c) 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
基金：
Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding [ZYLX201802]
第一作者单位：[1]Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R China
通讯作者：
通讯机构：[1]Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R China [*1]Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, No.95 Yong'an Rd, Xicheng District Beijing, 100050, P.R China.
推荐引用方式(GB/T 7714)：
Zhi Deyuan,Zhang Meng,Lin Jin,et al.Establishment and validation of the predictive model for the in-hospital death in patients with sepsis[J].AMERICAN JOURNAL of INFECTION CONTROL.2021,49(12):1515-1521.doi:10.1016/j.ajic.2021.07.010.
APA：
Zhi Deyuan,Zhang Meng,Lin Jin,Liu Pei,Wang Yajun&Duan Meili.(2021).Establishment and validation of the predictive model for the in-hospital death in patients with sepsis.AMERICAN JOURNAL of INFECTION CONTROL,49,(12)
MLA：
Zhi Deyuan,et al."Establishment and validation of the predictive model for the in-hospital death in patients with sepsis".AMERICAN JOURNAL of INFECTION CONTROL 49..12(2021):1515-1521
