Development of a machine learning model for predicting pediatric mortality in the early stages of intensive care unit admission.

Journal: Scientific reports
PMID:

Abstract

The aim of this study was to develop a predictive model of pediatric mortality in the early stages of intensive care unit (ICU) admission using machine learning. Patients less than 18 years old who were admitted to ICUs at four tertiary referral hospitals were enrolled. Three hospitals were designated as the derivation cohort for machine learning model development and internal validation, and the other hospital was designated as the validation cohort for external validation. We developed a random forest (RF) model that predicts pediatric mortality within 72 h of ICU admission, evaluated its performance, and compared it with the Pediatric Index of Mortality 3 (PIM 3). The area under the receiver operating characteristic curve (AUROC) of RF model was 0.942 (95% confidence interval [CI] = 0.912-0.972) in the derivation cohort and 0.906 (95% CI = 0.900-0.912) in the validation cohort. In contrast, the AUROC of PIM 3 was 0.892 (95% CI = 0.878-0.906) in the derivation cohort and 0.845 (95% CI = 0.817-0.873) in the validation cohort. The RF model in our study showed improved predictive performance in terms of both internal and external validation and was superior even when compared to PIM 3.

Authors

  • Bongjin Lee
    Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.
  • Kyunghoon Kim
    Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • Hyejin Hwang
    Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.
  • You Sun Kim
    Department of Pediatrics, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
  • Eun Hee Chung
    Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.
  • Jong-Seo Yoon
    Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • Hwa Jin Cho
    Department of Pediatrics, Chonnam National University Children's Hospital and Medical School, 42 Jebong-ro, Hak-dong, Dong-gu, Gwangju, South Korea. chhj98@gmail.com.
  • June Dong Park
    Department of Pediatrics, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea. jdparkmd@snu.ac.kr.