Predicting multiple organ dysfunction syndrome in trauma-induced sepsis: Nomogram and machine learning approaches

作者：Jinyu Peng, Yun Li, Chao Liu, Zhi Mao, Hongjun Kang, Feihu Zhou · 发表于：Journal of Intensive Medicine · 年份：2025 · DOI：10.1016/j.jointm.2024.12.008 · 被引用次数：7 · 研究领域：Sepsis Diagnosis and Treatment、Immune Response and Inflammation、Trauma, Hemostasis, Coagulopathy, Resuscitation

Background: Multiple organ dysfunction syndrome (MODS) is a critical complication in trauma-induced sepsis patients and is associated with a high mortality rate. This study aimed to develop and validate predictive models for MODS in this patient population using a nomogram and machine learning approaches. Methods: This retrospective cohort study utilized data from the Medical Information Mart for Intensive Care-IV 2.2 database, focusing on trauma patients diagnosed with sepsis within the first day of intensive care unit (ICU) admission. Predictive variables were extracted from the initial 24 h of ICU data. The dataset (2008-2019) was divided into a training set (2008-2016) and a temporal validation set (2017-2019). Feature selection was conducted using the Boruta algorithm. Predictive models were developed and validated using a nomogram and various machine learning techniques. Model performance was evaluated based on discrimination, calibration, and decision curve analysis. Results: <0.05). The nomogram achieved an area under the curve (AUC) of 0.757 (95% confidence interval [CI]: 0.700 to 0.814), while the random forest model demonstrated the highest performance with an AUC of 0.769 (95% CI: 0.712 to 0.826). Calibration plots showed excellent agreement between predicted and observed probabilities, and decision curve analysis indicated a consistently higher net benefit for the newly developed models. Conclusion: The nomogram and machine learning models provide enhanced predic...