Mount Sinai Develops Machine Learning Models to Predict Critical Illness and Mortality in COVID-19 Patients
Could Help Improve Patient Care, Health Outcomes, and Allocation of Hospital Resources
Mount Sinai researchers have developed machine learning models that predict the likelihood of critical events and mortality in COVID-19 patients within clinically relevant time windows. The new models outlined in the study—one of the first to use machine learning for risk prediction in COVID-19 patients among a large and diverse population, and published November 6 in the Journal of Medical Internet Research—could aid clinical practitioners at Mount Sinai and across the world in the care and management of COVID-19 patients.
“From the initial outburst of COVID-19 in New York City, we saw that COVID-19 presentation and disease course are heterogeneous and we have built machine learning models using patient data to predict outcomes,” said Benjamin Glicksberg, PhD, Assistant Professor of Genetics and Genomic Sciences at the Icahn School of Medicine at Mount Sinai, member of the Hasso Plattner Institute for Digital Health at Mount Sinai and Mount Sinai Clinical Intelligence Center (MSCIC), and one of the study’s principal investigators. “Now in the early stages of a second wave, we are much better prepared than before. We are currently assessing how these models can aid clinical practitioners in managing care of their patients in practice.”
In the retrospective study using electronic health records from more than 4,000 adult patients admitted to five Mount Sinai Health System hospitals from March to May, researchers and clinicians from the MSCIC analyzed characteristics of COVID-19 patients, including past medical history, comorbidities, vital signs, and laboratory test results at admission, to predict critical events such as intubation and mortality within various clinically relevant time windows that can forecast short and medium-term risks of patients over the hospitalization.
The researchers used the models to predict a critical event or mortality at time windows of 3, 5, 7, and 10 days from admission. At the one-week mark—which performed best overall, correctly flagging the most critical events while returning the fewest false positives—acute kidney injury, fast breathing, high blood sugar, and elevated lactate dehydrogenase (LDH) indicating tissue damage or disease were the strongest drivers in predicting critical illness. Older age, blood level imbalance, and C-reactive protein levels indicating inflammation, were the strongest drivers in predicting mortality.
“We have created high-performing predictive models using machine learning to improve the care of our patients at Mount Sinai,” said Girish Nadkarni, MD, Assistant Professor of Medicine (Nephrology) at the Icahn School of Medicine, Clinical Director of the Hasso Plattner Institute for Digital Health at Mount Sinai, and Co-Chair of MSCIC. “More importantly, we have created a method that identifies important health markers that drive likelihood estimates for acute care prognosis and can be used by health institutions across the world to improve care decisions, at both the physician and hospital level, and more effectively manage patients with COVID-19.”
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai advances medicine and health through unrivaled education and translational research and discovery to deliver care that is the safest, highest-quality, most accessible and equitable, and the best value of any health system in the nation. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture ambulatory surgery centers; more than 415 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. The Mount Sinai Hospital is ranked on U.S. News & World Report's "Honor Roll" of the top 20 U.S. hospitals and is top in the nation by specialty: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. Mount Sinai Kravis Children's Hospital is ranked in U.S. News & World Report’s “Best Children’s Hospitals” among the country’s best in four out of 10 pediatric specialties. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and No. 14 in the nation for National Institutes of Health funding. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.