A predictive model for sepsis risk in patients with non-traumatic cerebral hemorrhage based on the MIMIC-IV database

Abstract Patients with non-traumatic cerebral hemorrhage admitted to the intensive care unit (ICU) are known to be at high risk for developing sepsis. However, limited research exists to quantify this risk. Therefore, this study aimed to develop a reliable predictive model to assess the risk of seps...

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Main Authors: Xinxu Wu, Fangqi Hu, Tianpeng Zhang, Yunsong Pan, Jie He, Rui Zhang, Hui Zhou, Hui Shi
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-10119-6
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author Xinxu Wu
Fangqi Hu
Tianpeng Zhang
Yunsong Pan
Jie He
Rui Zhang
Hui Zhou
Hui Shi
author_facet Xinxu Wu
Fangqi Hu
Tianpeng Zhang
Yunsong Pan
Jie He
Rui Zhang
Hui Zhou
Hui Shi
author_sort Xinxu Wu
collection DOAJ
description Abstract Patients with non-traumatic cerebral hemorrhage admitted to the intensive care unit (ICU) are known to be at high risk for developing sepsis. However, limited research exists to quantify this risk. Therefore, this study aimed to develop a reliable predictive model to assess the risk of sepsis in ICU patients with non-traumatic cerebral hemorrhage. We extracted data on patients admitted to the ICU with non-traumatic cerebral hemorrhage from the Medical Information Mart for Intensive Care IV (MIMIC IV) database. Afterward, the patients were then randomized in a 7:3 ratio into a training set (N = 1,365) and a validation set (N = 585). Least Absolute Shrinkage and Selection Operator (LASSO) regression and stepwise logistic regression were employed to screen variables within the training set. The final logistic regression model was constructed using the identified key predictors. Finally, the model’s performance was evaluated using decision curves, calibration curves, and receiver operating characteristic (ROC) curves. A total of 1,950 patients were included in the study. The training and validation sets comprised 1,365 and 585 patients, respectively. The training set analysis revealed nine crucial predictors for secondary sepsis in ICU patients with non-traumatic cerebral hemorrhage. These factors included liver disease, acidosis, anemia, thrombocytopenia, urinary tract infection, invasive mechanical ventilation, Glasgow Coma Scale (GCS) scores, leukocyte counts, and blood calcium levels. These factors were incorporated into the final model. The area under the ROC curve (AUC) was 0.821 for the training set and 0.845 for the validation set, indicating the model’s high accuracy in predicting sepsis. Calibration curves demonstrated good agreement between the model’s predictions and actual outcomes. Furthermore, the decision curve analysis indicated that the model offers favorable clinical utility. This study successfully developed a dynamic nomogram model for predicting the risk of secondary sepsis in ICU patients with non-traumatic cerebral hemorrhage. The model is expected to provide valuable predictive information to facilitate timely interventions by healthcare professionals.
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spelling doaj-art-2ca3e93fa0144cf397e4f0ed8307b0c02025-08-20T04:02:55ZengNature PortfolioScientific Reports2045-23222025-07-0115111310.1038/s41598-025-10119-6A predictive model for sepsis risk in patients with non-traumatic cerebral hemorrhage based on the MIMIC-IV databaseXinxu Wu0Fangqi Hu1Tianpeng Zhang2Yunsong Pan3Jie He4Rui Zhang5Hui Zhou6Hui Shi7Department of Neurosurgery, Lianyungang Clinical Medical College, Xuzhou Medical UniversityDepartment of Neurosurgery, The First People’s Hospital of Lianyungang CityDepartment of Neurosurgery, Lianyungang Clinical Medical College, Xuzhou Medical UniversityDepartment of Neurosurgery, Lianyungang Clinical Medical College, Nanjing Medical UniversityDepartment of Neurosurgery, Lianyungang Clinical Medical College, Xuzhou Medical UniversityDepartment of Neurosurgery, Lianyungang Clinical Medical College, Xuzhou Medical UniversityDepartment of Neurosurgery, The First People’s Hospital of Lianyungang CityDepartment of Neurosurgery, The First People’s Hospital of Lianyungang CityAbstract Patients with non-traumatic cerebral hemorrhage admitted to the intensive care unit (ICU) are known to be at high risk for developing sepsis. However, limited research exists to quantify this risk. Therefore, this study aimed to develop a reliable predictive model to assess the risk of sepsis in ICU patients with non-traumatic cerebral hemorrhage. We extracted data on patients admitted to the ICU with non-traumatic cerebral hemorrhage from the Medical Information Mart for Intensive Care IV (MIMIC IV) database. Afterward, the patients were then randomized in a 7:3 ratio into a training set (N = 1,365) and a validation set (N = 585). Least Absolute Shrinkage and Selection Operator (LASSO) regression and stepwise logistic regression were employed to screen variables within the training set. The final logistic regression model was constructed using the identified key predictors. Finally, the model’s performance was evaluated using decision curves, calibration curves, and receiver operating characteristic (ROC) curves. A total of 1,950 patients were included in the study. The training and validation sets comprised 1,365 and 585 patients, respectively. The training set analysis revealed nine crucial predictors for secondary sepsis in ICU patients with non-traumatic cerebral hemorrhage. These factors included liver disease, acidosis, anemia, thrombocytopenia, urinary tract infection, invasive mechanical ventilation, Glasgow Coma Scale (GCS) scores, leukocyte counts, and blood calcium levels. These factors were incorporated into the final model. The area under the ROC curve (AUC) was 0.821 for the training set and 0.845 for the validation set, indicating the model’s high accuracy in predicting sepsis. Calibration curves demonstrated good agreement between the model’s predictions and actual outcomes. Furthermore, the decision curve analysis indicated that the model offers favorable clinical utility. This study successfully developed a dynamic nomogram model for predicting the risk of secondary sepsis in ICU patients with non-traumatic cerebral hemorrhage. The model is expected to provide valuable predictive information to facilitate timely interventions by healthcare professionals.https://doi.org/10.1038/s41598-025-10119-6Non-traumatic cerebral hemorrhageStrokeSepsisIntensive care unitMIMIC databaseDynamic nomogram
spellingShingle Xinxu Wu
Fangqi Hu
Tianpeng Zhang
Yunsong Pan
Jie He
Rui Zhang
Hui Zhou
Hui Shi
A predictive model for sepsis risk in patients with non-traumatic cerebral hemorrhage based on the MIMIC-IV database
Scientific Reports
Non-traumatic cerebral hemorrhage
Stroke
Sepsis
Intensive care unit
MIMIC database
Dynamic nomogram
title A predictive model for sepsis risk in patients with non-traumatic cerebral hemorrhage based on the MIMIC-IV database
title_full A predictive model for sepsis risk in patients with non-traumatic cerebral hemorrhage based on the MIMIC-IV database
title_fullStr A predictive model for sepsis risk in patients with non-traumatic cerebral hemorrhage based on the MIMIC-IV database
title_full_unstemmed A predictive model for sepsis risk in patients with non-traumatic cerebral hemorrhage based on the MIMIC-IV database
title_short A predictive model for sepsis risk in patients with non-traumatic cerebral hemorrhage based on the MIMIC-IV database
title_sort predictive model for sepsis risk in patients with non traumatic cerebral hemorrhage based on the mimic iv database
topic Non-traumatic cerebral hemorrhage
Stroke
Sepsis
Intensive care unit
MIMIC database
Dynamic nomogram
url https://doi.org/10.1038/s41598-025-10119-6
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