Dynamic mortality prediction in critically Ill children during interhospital transports to PICUs using explainable AI
Author(s)
Type
Journal Article
Abstract
Critically ill children who require inter-hospital transfers to paediatric intensive care units are sicker than other admissions and have higher mortality rates. Current transport practice primarily relies on early clinical assessments within the initial hours of transport. Real-time mortality risk during transport is lacking due to the absence of data-driven assessment tools. Addressing this gap, our research introduces the PROMPT (Patient-centred Real-time Outcome monitoring and Mortality PredicTion), an explainable end-to-end machine learning pipeline to forecast 30-day mortality risks. The PROMPT integrates continuous time-series vital signs and medical records with episode-specific transport data to provide real-time mortality prediction. The results demonstrated that with PROMPT, both the random forest and logistic regression models achieved the best performance with AUROC 0.83 (95% CI: 0.79–0.86) and 0.81 (95% CI: 0.76–0.85), respectively. The proposed model has demonstrated proof-of-principle in predicting mortality risk in transported children and providing individual-level model interpretability during inter-hospital transports.
Date Issued
2025-02-17
Date Acceptance
2025-01-15
Citation
npj Digital Medicine, 2025, 8
ISSN
2398-6352
Publisher
Nature Portfolio
Journal / Book Title
npj Digital Medicine
Volume
8
Issue
1
Copyright Statement
© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39962177
PII: 10.1038/s41746-025-01465-w
Subjects
Health Care Sciences & Services
Life Sciences & Biomedicine
Medical Informatics
MODEL
OUTCOMES
PEDIATRIC INTENSIVE-CARE
Science & Technology
Publication Status
Published
Coverage Spatial
England
Article Number
108
Date Publish Online
2025-02-17