Developing a predictive model for septic shock risk in acute pancreatitis patients using interpretable machine learning algorithms

Background Septic shock is a severe complication of acute pancreatitis (AP), often associated with poor prognosis. This study aims to analyze the clinical characteristics of patients with acute pancreatitis and develop an interpretable early prediction model for septic shock in these patients using...

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Main Authors: Binglin Song, Ping Liu, Kangrui Fu, Chun Liu
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Digital Health
Online Access:https://doi.org/10.1177/20552076251346361
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author Binglin Song
Ping Liu
Kangrui Fu
Chun Liu
author_facet Binglin Song
Ping Liu
Kangrui Fu
Chun Liu
author_sort Binglin Song
collection DOAJ
description Background Septic shock is a severe complication of acute pancreatitis (AP), often associated with poor prognosis. This study aims to analyze the clinical characteristics of patients with acute pancreatitis and develop an interpretable early prediction model for septic shock in these patients using machine learning (ML). The model is intended to assist emergency physicians in resource allocation and medical decision making. Methods Data were collected from the MIMIC-IV 3.0 database. The dataset was divided into a training set and a test set in a 7:3 ratio. Feature selection was performed using LASSO (Least Absolute Shrinkage and Selection Operator) regression. Subsequently, 10 ML models were developed: Random Forest, Logistic Regression, Gradient Boosting Machine, Neural Network, Extreme Gradient Boosting (XGBoost), K-Nearest Neighbor, Adaptive Boosting, Light Gradient Boosting Machine, Category Boosting, and Support Vector Machine. To enhance and optimize model interpretability, Shapley Additive Explanations (SHAP) were employed. Results A total of 1032 patients with AP were included in this study, from which 31 variables were selected for model development. By comparing the area under the receiver operating characteristic curve and decision curve analysis results between the training and test sets, the XGBoost model demonstrated a significant advantage over other models. SHAP analysis revealed that white blood cell count, total bilirubin (bilirubin total), and bicarbonate (HCO 3 – ) levels were the three most critical risk factors for the development of septic shock in patients with AP. Conclusion ML approaches exhibited promising performance in predicting septic shock in patients with AP. These models may aid in guiding treatment decisions for patients with AP in the emergency department.
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spelling doaj-art-0f44e9c4ebdb412b96fe98fad6589e672025-08-20T03:48:19ZengSAGE PublishingDigital Health2055-20762025-05-011110.1177/20552076251346361Developing a predictive model for septic shock risk in acute pancreatitis patients using interpretable machine learning algorithmsBinglin Song0Ping Liu1Kangrui Fu2Chun Liu3 Clinical Medical College, , China Emergency Department, , Dazhou, China Emergency Department, , Dazhou, China Emergency Department, , Dazhou, ChinaBackground Septic shock is a severe complication of acute pancreatitis (AP), often associated with poor prognosis. This study aims to analyze the clinical characteristics of patients with acute pancreatitis and develop an interpretable early prediction model for septic shock in these patients using machine learning (ML). The model is intended to assist emergency physicians in resource allocation and medical decision making. Methods Data were collected from the MIMIC-IV 3.0 database. The dataset was divided into a training set and a test set in a 7:3 ratio. Feature selection was performed using LASSO (Least Absolute Shrinkage and Selection Operator) regression. Subsequently, 10 ML models were developed: Random Forest, Logistic Regression, Gradient Boosting Machine, Neural Network, Extreme Gradient Boosting (XGBoost), K-Nearest Neighbor, Adaptive Boosting, Light Gradient Boosting Machine, Category Boosting, and Support Vector Machine. To enhance and optimize model interpretability, Shapley Additive Explanations (SHAP) were employed. Results A total of 1032 patients with AP were included in this study, from which 31 variables were selected for model development. By comparing the area under the receiver operating characteristic curve and decision curve analysis results between the training and test sets, the XGBoost model demonstrated a significant advantage over other models. SHAP analysis revealed that white blood cell count, total bilirubin (bilirubin total), and bicarbonate (HCO 3 – ) levels were the three most critical risk factors for the development of septic shock in patients with AP. Conclusion ML approaches exhibited promising performance in predicting septic shock in patients with AP. These models may aid in guiding treatment decisions for patients with AP in the emergency department.https://doi.org/10.1177/20552076251346361
spellingShingle Binglin Song
Ping Liu
Kangrui Fu
Chun Liu
Developing a predictive model for septic shock risk in acute pancreatitis patients using interpretable machine learning algorithms
Digital Health
title Developing a predictive model for septic shock risk in acute pancreatitis patients using interpretable machine learning algorithms
title_full Developing a predictive model for septic shock risk in acute pancreatitis patients using interpretable machine learning algorithms
title_fullStr Developing a predictive model for septic shock risk in acute pancreatitis patients using interpretable machine learning algorithms
title_full_unstemmed Developing a predictive model for septic shock risk in acute pancreatitis patients using interpretable machine learning algorithms
title_short Developing a predictive model for septic shock risk in acute pancreatitis patients using interpretable machine learning algorithms
title_sort developing a predictive model for septic shock risk in acute pancreatitis patients using interpretable machine learning algorithms
url https://doi.org/10.1177/20552076251346361
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