Artificial intelligence based multispecialty mortality prediction models for septic shock in a multicenter retrospective study

Septic shock is one of the most lethal conditions in ICU, and early risk prediction may help reduce mortality. We developed a TOPSIS-based Classification Fusion (TCF) model to predict mortality risk in septic shock patients using data from 4872 ICU patients from February 2003 to November 2023 across three hospitals. The model integrates seven machine learning models via the Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS), achieving AUCs of 0.733 in internal validation, 0.808 in the pediatric ICU, 0.662 in the respiratory ICU, with external validation AUCs of 0.784 and 0.786, respectively. It demonstrated high stability and accuracy in cross-specialty and multi-center validation. This interpretable model provides clinicians with a reliable early-warning tool for septic shock mortality risk, facilitating early intervention to reduce mortality.