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Prediction of SEPSIS

What is SEPSIS?

SEPSIS is a serious condition that happens when the body's immune system has an extreme response to an infection. In simple words when the body responds improperly to an infection and damage its own tissues and organs. Sepsis may progress to septic shock. This is a dramatic drop in blood pressure that can damage the heart, lungs, kidneys, liver and other organs too. Sepsis can affect anyone, but the people those who are older, pregnant women or have other related health issues are at higher risk.


Biomarkers of SEPSIS:

Let's discuss about some of the Bio markers of SEPSIS below in the description. Few biomarkers like PatientId, age and gender will be present in the dataset.


Hour: The hour of the patient's stay in the hospital, starting from 0 and increasing by 1 for each hour. The variable indicates the time point in which the patient's vital signs and laboratory values are measured. Hour of SEPSIS is a valuable biomarker that can help to prioritize sepsis patients and initiate timely interventions. Onset of Sepsis identified between 12 to 24 hours.

HR: The ideal range for HR is from 60 to 100 beats per minute. The abnormal HR range can be too fast which is above 100 bpm or can be slow which is below 60 bpm.

O2Sat: A normal pulse reading for oxygen saturation (O2Sat) level is between 95% and 100%.

SBP: SBP stands for Systolic Blood Pressure. In medical terms the maximum pressure during contraction of the ventricles. The ideal range should be less than 120 mmHG. The abnormal ranges are If it falls between 120 to 129 it's in elevated, If it falls between 130 to 139 it's in a stage 1 blood pressure & If it is more than 140 then it's in a stage 2 blood pressure.

DBP: DBP stands for Diastolic Blood Pressure which means minimum pressure recorded just prior to the next contraction.The ideal range should be less than 80 mmHG. If it falls between 80 to 89 it's in stage 1 Hypertension, more than 90 it's in stage 2 Hypertension & more than 120 it leads toward the Hypertensive crisis.

MAP: MAP stands for Mean Arterial Pressure. An ideal range for MAP is between 70 and 100 mm HG. If the MAP drops below 60 mm HG then patient may be experiencing low artery pressure and if the MAP is above 100 mm HG then it will be considered as high artery pressure.

Resp: Normal respiration rates for an adult person range from 12 to 16 breaths per minute.

EtCO2: EtCO2 means End Tidal CO2, which is related to the level of carbon dioxide that is released while we exhaled. The ideal range of EtCO2 should between 35 to 40 mm HG or 4.0 - 5.7 kPa.

Base Excess: Base Excess is the amount of acid that is required to normalize the pH of the blood. The value is usually reported as a concentration in units of mEq/L, with positive number indicating an excess of base and negative a deficit. An ideal range for base excess is -2 to +2 mEq/L.

HCO3: The ideal range for Bicarbonate (HCO3) is 22 to 28 milliequivqlents per liter(mEq/L).

FiO2: FiO2 stands for Fraction of Inspired Oxygen. Natural air includes 21% oxygen, which is equivalent to FiO2 of 0.21. Oxygen-enriched air has a higher FiO2 than 0.21, up to 1.00 which is 100% oxygen. FiO2 is typically maintained below 0.5 even with mechanical ventilation.

pH: pH of the human body ranges between 7.35 to 7.45, with the average at 7.40. Acidity and Alkalinity are expressed on the pH scale, which ranges from 0 (strongly acidic) to 14 (strongly basic or alkaline).

PaCO2:The normal range for Partial pressure of carbon dioxide (PaCO2) is from 38 to 42 mm HG (5.1 to 5.6 kPa).

SaO2: Oxygen saturation levels (SaO2) ranging between 95% and 100% are considered normal. SaO2 level below 90% indicates hypoxemia and if it is below 70%, the outcome is fatal.

AST: Aspertate aminotransferase(AST) is an enzyme which is mostly found in liver and as well as in muscles. The normal range is 8 to 33 U/L.

BUN: Blood Urea Nitrogen (BUN) is considered to be normal when the range is from 6 to 24 mg/dL (2.1 to 8.5 mmol/L).

Alkalinephos: ALP is an enzyme found through out the body, but mostly found in the liver, kidneys, bones and digestive system. Alkaline Phosphatase(ALP) normal range is 44 to 147 IU/L or 0.73 to 2.45 microkatal per liter.

Calcium Chloride: The human body contains about 1200g of calcium(or 300 to 500 mmol per Kg body weight), approximately 99% which is found in the skeleton. The normal concentration of calcium in plasma is between 2.15 to 2.60 mol per liter.

Creatinine: An ideal range for Creatinine is 0.7 to 1.3 mg/dL (61.9 to 114.9 micro mol/L) for men and 0.6 to 1.1 mg/dL (53 to 97.2 micro mol/L) for women. Creatinine exists your body as a waste product in urine.

Bilirubin-direct: It is normal to have some bilirubin in the blood. The normal level of direct bilirubin is less than 0.3 mg/dL and the ideal range of total bilirubin is 0.1 to 1.2 mg/dL.

Glucose: A fasting blood sugar level less than 100 mg/dL(5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL(5.6 to 6.9 mmol/L) is considered as prediabetes. if it is 126 mg/dL or higher then considered as diabetes.

Lactate: Lactate level is less than 2mmol/L is considered as normal. Lactate level ranges between 2mmol/L to 4mmol/L is considered as hyperlactatemia. More than 4mmol/L indicates severe level.

Magnesium: The ideal range of magnesium is 1.8 to 2.6 mg/dL for adults where the range from 1.7 to 2.1 mg/dL is considered normal for children. Magnesium is needed for healthy bones, muscles, heart and nerves.

Phosphate: The normal range for phosphate is 2.5 to 4.5 mg/dL (0.81 to 1.45 mmol/L). Lower level of phosphate from normal range is considered as hypophosphatemia and higher level of phosphate from normal range is considered as hyperphosphatemia.

Potassium: The Ideal range of potassium is between 3.5 to 5.2 mEq/L(3.5 to 5.2 mmol/L). Higher than 6.0 mmol/L can be dangerous and requires immediate treatment.

Troponin l: The ideal range for troponin l is between 0 to 0.04 ng/ml. Troponin l is basically a protein found in cardiac muscle which plays a crucial role in regulating muscle contraction.

Hct: The hematocrit usually measures the volume of red blood cells compared to the total blood volume. The normal hematocrit is 40% to 54% for men and 36% to 48% for women.If it is higher than this then your body is making too many red blood cells.

Hgb: The normal hemoglobin (Hgb) level for men is 14 to 18 g/dl and for female the level is 12 to 16 g/dl. If something falls under this range considered as low hemoglobin.

PTT: The normal range of PTT is between 25 to 35. PTT is measured in seconds to clot formation. PTT level is high means your blood is taking longer to clot than it should. A lower PTT level means that your blood is clotting faster than normal.

WBC: A White Blood Cell count of less than 4000 per microliter indicates leukopenia. A WBC count of more than 12000 indicates leukocytosis. leukemia  may have WBC count in the 100,000-400,000 range . The WBC is most commonly used metric to investigate infection,but is also least useful . Sepsis shock may cause either leukocytosis or leukopenia.

Fibrinogen: The normal value for fibrinogen is between 200 to 400 mg/dL. If it is less than 50mg/dL then you are in danger of bleeding after surgery. If it more than 700mg/dL then you are in danger of forming clots that could harm your heart and brain.

Platelets: A normal platelet count ranges from 1,50,000 to 4,50,000 platelets per microliter pf blood. Having more than 4,50,000 platelets is a condition called thrombocytosis. Having less than 1,50,000 platelets is a condition called thrombocytopenia.

Unit1: Administrative identifier for ICU unit (MICU) ; false(0) or true(1). Medical ICU is a specialized unit that provides intensive care for patients with sepsis and other critical illnesses. Medical ICU can help improve the outcomes of sepsis patients by providing timely diagnosis, appropriate antimicrobial therapy, fluid resuscitation, organ support and monitoring of vital signs and laboratory parameters. Medical ICU can also prevent or treat complications of sepsis, such as acute kidney injury, respiratory distress syndrome, cardiac arrhythmia and disseminated intravascular coagulation.

Unit2: Administrative identifier for ICU unit (SICU) ; false(0) or true(1). The surgical intensive care unit (SICU) is where you receive care if you're critically ill and in need of surgery or recovering from surgery. You may be too unstable to be treated on a regular nursing floor or ICU-level monitoring may be the protocol for a particular procedure.

HospAdm Time: A person may be directly admitted to the ICU for the treatment of sepsis or a person can be admitted to the hospital and later develop sepsis, requiring a transfer to the ICU.

ICULOS: The highest percentage of patients managed for less than one month. Sepsis usually doesn't require admission to the ICU unless it becomes severe. Sepsis may be the final stage in a chronic disease, especially in patients with immunosuppression.

SepsisLabel: When a patient is admitted to a hospital, if sepsis label is 0 (No sepsis on admission), if sepsis label is 0 and 1 (No sepsis on admission and then converted to sepsis), if sepsis label is 1 (Sepsis on admission).


Conclusion: SEPSIS is your body's overactive and extreme response to infection. It is highly heterogeneous, genetically complex syndrome initiated by infection and characterized by SIRS with variable progression and outcome. Sepsis is a life-threatening medical emergency. Without quick treatment, it can lead to tissue damage organ failure and even death. These biomarkers ranges may find a possible role in diagnosis.


I hope this blog gives some valuable information about the biomarkers during SEPSIS.


Thank you for reading this blog!


References:









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