Survival analysis for sepsis patients: A machine learning approach to feature selection and predictive modeling

Abstract Sepsis is a life-threatening condition that presents substantial challenges to healthcare and pharmacological management due to its high mortality rates and complex patient responses. Accurately predicting patient outcomes is essential for optimizing therapeutic interventions and improving...

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Main Authors: Kaida Cai, Xiaofang Yang, Zhengyan Wang, Wenzhi Fu, Hanwen Liu, Fatemeh Mahmoudi
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-025-05876-3
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author Kaida Cai
Xiaofang Yang
Zhengyan Wang
Wenzhi Fu
Hanwen Liu
Fatemeh Mahmoudi
author_facet Kaida Cai
Xiaofang Yang
Zhengyan Wang
Wenzhi Fu
Hanwen Liu
Fatemeh Mahmoudi
author_sort Kaida Cai
collection DOAJ
description Abstract Sepsis is a life-threatening condition that presents substantial challenges to healthcare and pharmacological management due to its high mortality rates and complex patient responses. Accurately predicting patient outcomes is essential for optimizing therapeutic interventions and improving clinical decision-making. This study evaluates the predictive performance of the Cox proportional hazards model and advanced machine learning techniques, such as extreme gradient boosting (XGBoost), gradient boosting machine (GBM), and random survival forests (RSF), in forecasting survival outcomes for sepsis patients. Feature selection methods, including adaptive elastic net (AEN), smoothly clipped absolute deviation (SCAD), minimax concave penalty (MCP), and information gain (IG), were employed to refine model performance by identifying the most relevant clinical features. The results demonstrate that XGBoost consistently outperforms the Cox model, achieving a higher concordance index and demonstrating superior accuracy in handling complex, non-linear clinical interactions. The integration of feature selection further enhanced the machine learning models’ predictive capabilities. These findings emphasize the potential of machine learning techniques to improve outcome prediction and guide personalized treatment strategies, offering valuable tools for critical care settings.
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id doaj-art-7dc63f0d73be4a45b2c11a7487fd4e3c
institution Kabale University
issn 2045-2322
language English
publishDate 2025-07-01
publisher Nature Portfolio
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series Scientific Reports
spelling doaj-art-7dc63f0d73be4a45b2c11a7487fd4e3c2025-08-20T03:45:26ZengNature PortfolioScientific Reports2045-23222025-07-0115111810.1038/s41598-025-05876-3Survival analysis for sepsis patients: A machine learning approach to feature selection and predictive modelingKaida Cai0Xiaofang Yang1Zhengyan Wang2Wenzhi Fu3Hanwen Liu4Fatemeh Mahmoudi5School of Public Health, Southeast UniversitySchool of Mathematics, Southeast UniversitySchool of Mathematics, Southeast UniversitySchool of Mathematics, Southeast UniversitySchool of Mathematics, Southeast UniversityDepartment of Mathematics and Computing, Faculty of Science and Technology, Mount Royal UniversityAbstract Sepsis is a life-threatening condition that presents substantial challenges to healthcare and pharmacological management due to its high mortality rates and complex patient responses. Accurately predicting patient outcomes is essential for optimizing therapeutic interventions and improving clinical decision-making. This study evaluates the predictive performance of the Cox proportional hazards model and advanced machine learning techniques, such as extreme gradient boosting (XGBoost), gradient boosting machine (GBM), and random survival forests (RSF), in forecasting survival outcomes for sepsis patients. Feature selection methods, including adaptive elastic net (AEN), smoothly clipped absolute deviation (SCAD), minimax concave penalty (MCP), and information gain (IG), were employed to refine model performance by identifying the most relevant clinical features. The results demonstrate that XGBoost consistently outperforms the Cox model, achieving a higher concordance index and demonstrating superior accuracy in handling complex, non-linear clinical interactions. The integration of feature selection further enhanced the machine learning models’ predictive capabilities. These findings emphasize the potential of machine learning techniques to improve outcome prediction and guide personalized treatment strategies, offering valuable tools for critical care settings.https://doi.org/10.1038/s41598-025-05876-3Machine learningSurvival analysisFeature selectionMissing data imputationSepsis
spellingShingle Kaida Cai
Xiaofang Yang
Zhengyan Wang
Wenzhi Fu
Hanwen Liu
Fatemeh Mahmoudi
Survival analysis for sepsis patients: A machine learning approach to feature selection and predictive modeling
Scientific Reports
Machine learning
Survival analysis
Feature selection
Missing data imputation
Sepsis
title Survival analysis for sepsis patients: A machine learning approach to feature selection and predictive modeling
title_full Survival analysis for sepsis patients: A machine learning approach to feature selection and predictive modeling
title_fullStr Survival analysis for sepsis patients: A machine learning approach to feature selection and predictive modeling
title_full_unstemmed Survival analysis for sepsis patients: A machine learning approach to feature selection and predictive modeling
title_short Survival analysis for sepsis patients: A machine learning approach to feature selection and predictive modeling
title_sort survival analysis for sepsis patients a machine learning approach to feature selection and predictive modeling
topic Machine learning
Survival analysis
Feature selection
Missing data imputation
Sepsis
url https://doi.org/10.1038/s41598-025-05876-3
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AT zhengyanwang survivalanalysisforsepsispatientsamachinelearningapproachtofeatureselectionandpredictivemodeling
AT wenzhifu survivalanalysisforsepsispatientsamachinelearningapproachtofeatureselectionandpredictivemodeling
AT hanwenliu survivalanalysisforsepsispatientsamachinelearningapproachtofeatureselectionandpredictivemodeling
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