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Updated: Jul 12, 2025
Evaluation of a Reliable Biomarker in a Cecal Ligation and Puncture-Induced Mouse Model of Sepsis
Published on: December 9, 2022
Explainable machine learning using perioperative serial laboratory results to predict postoperative mortality in
Seung Hee Lim1, Min Jeong Kim1, Won Hyuk Choi1
1Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Purpose:
Sepsis is one of the most common causes of death after surgery. Several conventional scoring systems have been developed to predict the outcome of sepsis; however, their predictive power is insufficient. The present study applies explainable machine-learning algorithms to improve the accuracy of predicting postoperative mortality in patients with sepsis caused by peritonitis.
Methods:
We performed a retrospective analysis of data from demographic, clinical, and laboratory analyses, including the delta neutrophil index (DNI), WBC and neutrophil counts, and CRP level. Laboratory data were measured before surgery, 12-36 hours after surgery, and 60-84 hours after surgery. The primary study output was the probability of mortality. The areas under the receiver operating characteristic curves (AUCs) of several machine-learning algorithms using the Sequential Organ Failure Assessment (SOFA) and Simplified Acute Physiology Score (SAPS) 3 models were compared. 'SHapley Additive exPlanations' values were used to indicate the direction of the relationship between a variable and mortality.
Results:
The CatBoost model yielded the highest AUC (0.933) for mortality compared to SAPS3 and SOFA (0.860 and 0.867, respectively). Increased DNI on day 3, septic shock, use of norepinephrine therapy, and increased international normalized ratio on day 3 had the greatest impact on the model's prediction of mortality.
Conclusion:
Machine-learning algorithms increase the accuracy of predicting postoperative mortality in patients with sepsis caused by peritonitis.
