[Study on the diagnosis model of sepsis based on Medical Information Mart for Intensive Care-IV database].

OBJECTIVE: To explore the diagnostic model of sepsis based on Medical Information Mart for Intensive Care-IV (MIMIC-IV). METHODS: The clinical data of septic patients admitted to intensive care unit (ICU) with MIMIC-IV database, including demographic characteristics, disease severity scores [Simplified Acute Physiology Score II (SAPS II), Logistic Organ Failure Score (LODS), Oxford Acute Disease Severity Score (OASIS), Sequential Organ Failure Assessment (SOFA)], vital signs and laboratory indicators (blood routine, serum electrolytes, blood gas analysis, blood glucose, liver and kidney function, coagulation function, blood culture results) at ICU admission, underlying disease, site of infection and whether shock was combined were retrospectively analyzed. The primary outcome indicator was 28-day death. The patients were divided into survival group and death group according to 28-day prognosis. The differences in various indicators between the two groups were compared, and the indicators with differences between the two groups were incorporated into the classification tree model to screen out the top 5 indexes of importance for predicting the 28-day death in septic patients, which were enrolled in the diagnostic model of sepsis. Receiver Operator characteristic curve (ROC curve) was used to screened out the scoring system with the greatest predictive value for 28-day death in septic patients from four disease severity scores, which was enrolled in the diagnosis model of sepsis. RESULTS: , alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time (PT), activated partial thromboplastin time (APTT), blood urea nitrogen (BUN), serum creatinine (SCr)] and ratio of positive blood culture, infection site and combined with shock were statistically significant differences between the two groups (all P