Assessing patient risk of central line-associated bacteremia via machine learning

Publication date: Available online 13 April 2018
Source:American Journal of Infection Control
Author(s): Cole Beeler, Lana Dbeibo, Kristen Kelley, Levi Thatcher, Douglas Webb, Amadou Bah, Patrick Monahan, Nicole R. Fowler, Spencer Nicol, Alisa Judy-Malcolm, Jose Azar
BackgroundCentral line-associated bloodstream infections (CLABSIs) contribute to increased morbidity, length of hospital stay, and cost. Despite progress in understanding the risk factors, there remains a need to accurately predict the risk of CLABSIs and, in real time, prevent them from occurring.MethodsA predictive model was developed using retrospective data from a large academic healthcare system. Models were developed with machine learning via construction of random forests using validated input variables.ResultsFifteen variables accounted for the most significant effect on CLABSI prediction based on a retrospective study of 70,218 unique patient encounters between January 1, 2013, and May 31, 2016. The area under the receiver operating characteristic curve for the best-performing model was 0.82 in production.DiscussionThis model has multiple applications for resource allocation for CLABSI prevention, including serving as a tool to target patients at highest risk for potentially cost-effective but otherwise time-limited interventions.ConclusionsMachine learning can be used to develop accurate models to predict the risk of CLABSI in real time prior to the development of infection.



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