Machine learning models for predicting in-hospital mortality from acute pancreatitis in intensive care unit

Abstract Background Acute pancreatitis (AP) represents a critical medical condition where timely and precise prediction of in-hospital mortality is crucial for guiding optimal clinical management. This study focuses on the development of advanced machine learning (ML) models to accurately predict in...

Full description

Saved in:
Bibliographic Details
Main Authors: Shuxing Wei, Hongmeng Dong, Weidong Yao, Ying Chen, Xiya Wang, Wenqing ji, Yongsheng Zhang, Shubin Guo
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Medical Informatics and Decision Making
Subjects:
Online Access:https://doi.org/10.1186/s12911-025-03033-4
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849704752769662976
author Shuxing Wei
Hongmeng Dong
Weidong Yao
Ying Chen
Xiya Wang
Wenqing ji
Yongsheng Zhang
Shubin Guo
author_facet Shuxing Wei
Hongmeng Dong
Weidong Yao
Ying Chen
Xiya Wang
Wenqing ji
Yongsheng Zhang
Shubin Guo
author_sort Shuxing Wei
collection DOAJ
description Abstract Background Acute pancreatitis (AP) represents a critical medical condition where timely and precise prediction of in-hospital mortality is crucial for guiding optimal clinical management. This study focuses on the development of advanced machine learning (ML) models to accurately predict in-hospital mortality among AP patients admitted to intensive care unit (ICU). Method Our study utilized data from three distinct sources: the Medical Information Mart for Intensive Care III (MIMIC-III), MIMIC-IV databases, and Beijing Chaoyang Hospital. We systematically developed and evaluated 11 distinct machine learning (ML) models, employing a comprehensive set of evaluation metrics to assess model performance, including the area under the curve (AUC). To enhance interpretability and identify key predictive features, we implemented Shapley Additive Explanations (SHAP) analysis for the top-performing model. Furthermore, we developed a streamlined version of the model through strategic feature reduction, followed by rigorous hyperparameter optimization (HPO) to maximize predictive performance. To facilitate clinical implementation, we designed and deployed an intuitive web-based calculator, enabling convenient access and practical application of our optimized predictive model. Result The study analyzed 1802 AP patients, with 266 (14.8%) experiencing in-hospital mortality. A set of 27 features was utilized to construct various models, and among them, CatBoost demonstrated the highest performance in both the validation and test sets. To create a more concise model, we selected the top 13 features. After HPO, the AUC in the test set reached 0.835 (95% CI: 0.793–0.872), the AUC in the external validation from Beijing Chaoyang hospital was 0.782 (95% CI: 0.699–0.860). Conclusion ML models have shown promising reliability in predicting in-hospital mortality among patients with AP in the ICU. Among these models, the CatBoost model exhibits superior predictive performance, providing valuable assistance to clinical practitioners in identifying high-risk patients and facilitating early interventions to enhance prognosis. The development of a compact model and a web-based calculator further enhances the convenience of using these models in clinical practice.
format Article
id doaj-art-83dc276d27be4aaf85f28588bb3b0886
institution DOAJ
issn 1472-6947
language English
publishDate 2025-05-01
publisher BMC
record_format Article
series BMC Medical Informatics and Decision Making
spelling doaj-art-83dc276d27be4aaf85f28588bb3b08862025-08-20T03:16:40ZengBMCBMC Medical Informatics and Decision Making1472-69472025-05-0125111210.1186/s12911-025-03033-4Machine learning models for predicting in-hospital mortality from acute pancreatitis in intensive care unitShuxing Wei0Hongmeng Dong1Weidong Yao2Ying Chen3Xiya Wang4Wenqing ji5Yongsheng Zhang6Shubin Guo7Emergency Medicine Clinical Research Center, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing Chaoyang Hospital, Affiliated to Capital Medical UniversityEmergency Medicine Clinical Research Center, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing Chaoyang Hospital, Affiliated to Capital Medical UniversityDepartment of Anesthesiology, Second Affiliated Hospital of Shandong University of Traditional Chinese MedicineEmergency Medicine Clinical Research Center, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing Chaoyang Hospital, Affiliated to Capital Medical UniversityEmergency Medicine Clinical Research Center, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing Chaoyang Hospital, Affiliated to Capital Medical UniversityEmergency Medicine Clinical Research Center, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing Chaoyang Hospital, Affiliated to Capital Medical UniversityDepartment of Health Management, Shandong Engineering Laboratory of Health Management, Institute of Health Management, the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan HospitalEmergency Medicine Clinical Research Center, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing Chaoyang Hospital, Affiliated to Capital Medical UniversityAbstract Background Acute pancreatitis (AP) represents a critical medical condition where timely and precise prediction of in-hospital mortality is crucial for guiding optimal clinical management. This study focuses on the development of advanced machine learning (ML) models to accurately predict in-hospital mortality among AP patients admitted to intensive care unit (ICU). Method Our study utilized data from three distinct sources: the Medical Information Mart for Intensive Care III (MIMIC-III), MIMIC-IV databases, and Beijing Chaoyang Hospital. We systematically developed and evaluated 11 distinct machine learning (ML) models, employing a comprehensive set of evaluation metrics to assess model performance, including the area under the curve (AUC). To enhance interpretability and identify key predictive features, we implemented Shapley Additive Explanations (SHAP) analysis for the top-performing model. Furthermore, we developed a streamlined version of the model through strategic feature reduction, followed by rigorous hyperparameter optimization (HPO) to maximize predictive performance. To facilitate clinical implementation, we designed and deployed an intuitive web-based calculator, enabling convenient access and practical application of our optimized predictive model. Result The study analyzed 1802 AP patients, with 266 (14.8%) experiencing in-hospital mortality. A set of 27 features was utilized to construct various models, and among them, CatBoost demonstrated the highest performance in both the validation and test sets. To create a more concise model, we selected the top 13 features. After HPO, the AUC in the test set reached 0.835 (95% CI: 0.793–0.872), the AUC in the external validation from Beijing Chaoyang hospital was 0.782 (95% CI: 0.699–0.860). Conclusion ML models have shown promising reliability in predicting in-hospital mortality among patients with AP in the ICU. Among these models, the CatBoost model exhibits superior predictive performance, providing valuable assistance to clinical practitioners in identifying high-risk patients and facilitating early interventions to enhance prognosis. The development of a compact model and a web-based calculator further enhances the convenience of using these models in clinical practice.https://doi.org/10.1186/s12911-025-03033-4Acute pancreatitisIntensive care unitMachine learningMortalityDecision-making
spellingShingle Shuxing Wei
Hongmeng Dong
Weidong Yao
Ying Chen
Xiya Wang
Wenqing ji
Yongsheng Zhang
Shubin Guo
Machine learning models for predicting in-hospital mortality from acute pancreatitis in intensive care unit
BMC Medical Informatics and Decision Making
Acute pancreatitis
Intensive care unit
Machine learning
Mortality
Decision-making
title Machine learning models for predicting in-hospital mortality from acute pancreatitis in intensive care unit
title_full Machine learning models for predicting in-hospital mortality from acute pancreatitis in intensive care unit
title_fullStr Machine learning models for predicting in-hospital mortality from acute pancreatitis in intensive care unit
title_full_unstemmed Machine learning models for predicting in-hospital mortality from acute pancreatitis in intensive care unit
title_short Machine learning models for predicting in-hospital mortality from acute pancreatitis in intensive care unit
title_sort machine learning models for predicting in hospital mortality from acute pancreatitis in intensive care unit
topic Acute pancreatitis
Intensive care unit
Machine learning
Mortality
Decision-making
url https://doi.org/10.1186/s12911-025-03033-4
work_keys_str_mv AT shuxingwei machinelearningmodelsforpredictinginhospitalmortalityfromacutepancreatitisinintensivecareunit
AT hongmengdong machinelearningmodelsforpredictinginhospitalmortalityfromacutepancreatitisinintensivecareunit
AT weidongyao machinelearningmodelsforpredictinginhospitalmortalityfromacutepancreatitisinintensivecareunit
AT yingchen machinelearningmodelsforpredictinginhospitalmortalityfromacutepancreatitisinintensivecareunit
AT xiyawang machinelearningmodelsforpredictinginhospitalmortalityfromacutepancreatitisinintensivecareunit
AT wenqingji machinelearningmodelsforpredictinginhospitalmortalityfromacutepancreatitisinintensivecareunit
AT yongshengzhang machinelearningmodelsforpredictinginhospitalmortalityfromacutepancreatitisinintensivecareunit
AT shubinguo machinelearningmodelsforpredictinginhospitalmortalityfromacutepancreatitisinintensivecareunit