Utilizing Machine Learning Models to Predict Acute Kidney Injury in Septic Patients from MIMIC-III Database

Abstract

Sepsis is a severe condition that causes the body to respond incorrectly to an infection. This reaction can subsequently cause organ failure, a major one being acute kidney injury (AKI). For septic patients, approximately 50% develop AKI, with a mortality rate above 40%. Creating models that can accurately predict AKI based on specific qualities of septic patients is crucial for early detection and intervention. Using medical data from septic patients during intensive care unit (ICU) admission from the Medical Information Mart for Intensive Care 3 (MIMIC-III) database, we extracted 3301 patients with sepsis, with 73% of patients developing AKI. The data was randomly divided into a training set (n = 1980, 40%), a test set (n = 661, 10%), and a validation set (n = 660, 50%). The proposed model was logistic regression, and it was compared against five baseline models: XGBoost, K Nearest Neighbors (KNN), Support Vector Machines (SVM), Random Forest (RF), and LightGBM. Area Under the Curve (AUC), Accuracy, F1-Score, and Recall were calculated for each model. After analysis, we were able to select 23 features to include in our model, the top features being urine output, maximum bilirubin, minimum bilirubin, weight, maximum blood urea nitrogen, and minimum estimated glomerular filtration rate. The logistic regression model performed the best, achieving an AUC score of 0.887 (95% CI: [0.861-0.915]), an accuracy of 0.817, an F1 score of 0.866, a recall score of 0.827, and a Brier score of 0.13. Compared to the best existing literature in this field, our model achieved an 8.57% improvement in AUC while using 13 fewer variables, showcasing its effectiveness in determining AKI in septic patients. While the features selected for predicting AKI in septic patients are similar to previous literature, the top features that influenced our model's performance differ.