Early prediction of sepsis using an XGBoost model with single time-point non-invasive vital signs and its correlation with C-reactive protein and procalcitonin: A multi-center study

Abstract

We aimed to develop an early warning system to predict sepsis based solely on single time-point and non-invasive vital signs, and to evaluate its correlation with related biomarkers, namely C-reactive protein (CRP) and Procalcitonin (PCT). We utilized retrospective data from Physionet and four medical centers in Taiwan, encompassing a total of 46,184 Intensive Care Unit (ICU) patients, to develop and validate a machine learning algorithm based on XGBoost for predicting sepsis. The model was specifically designed to use non-invasive vital signs captured at a single time point, The correlation between sepsis AI prediction model and levels of CRP and PCT was evaluated. The developed model demonstrated balanced performance across various datasets, with an average recall of 0.908 and precision of 0.577. The model's performance was further validated by the independent dataset from Cheng-Hsin General Hospital (recall: 0.986, precision: 0.585). Temperature, systolic blood pressure, and respiration rate were the top contributing predictors in the model. A significant correlation was observed between the model's sepsis predictions and elevated CRP levels, while PCT showed a less consistent pattern. Our approach, combining AI algorithms with vital sign data and its clinical relevance to CRP level, offers a more precise and timely sepsis detection, with the potential to improve care in emergency and critical care settings.