{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:53:47Z","timestamp":1791262427598,"version":"4.1.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"the Yancheng Science and Technology Bureau","award":["YCBE202365"],"award-info":[{"award-number":["YCBE202365"]}]},{"name":"the Jiangsu Vocational College of Medicine's School-Local Collaborative Innovation Research Project","award":["202491001"],"award-info":[{"award-number":["202491001"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"DOI":"10.1186\/s12879-025-10982-8","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T09:47:15Z","timestamp":1745401635000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Interpretable machine learning model for predicting delirium in patients with sepsis: a study based on the MIMIC data"],"prefix":"10.1186","volume":"25","author":[{"given":"Jing","family":"Fu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aifeng","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lulu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangquan","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiqiang","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,23]]},"reference":[{"key":"10982_CR1","doi-asserted-by":"crossref","unstructured":"Atterton B, Paulino MC, Povoa P, et al. Sepsis associated delirium. Medicina (Kaunas) 2020;56(5):240.","DOI":"10.3390\/medicina56050240"},{"key":"10982_CR2","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1007\/s00134-021-06503-1","volume":"47","author":"JL Stollings","year":"2021","unstructured":"Stollings JL, Kotfis K, Chanques G, et al. Delirium in critical illness: clinical manifestations, outcomes, and management. Intensive Care Med. 2021;47:1089\u2013103.","journal-title":"Intensive Care Med"},{"key":"10982_CR3","doi-asserted-by":"publisher","first-page":"e49193","DOI":"10.15252\/embr.201949193","volume":"21","author":"K Van Looveren","year":"2020","unstructured":"Van Looveren K, Van Wyngene L, Libert C. An extracellular microRNA can rescue lives in sepsis. EMBO Rep. 2020;21:e49193.","journal-title":"EMBO Rep"},{"key":"10982_CR4","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1186\/s40001-024-02071-4","volume":"29","author":"H Yu","year":"2024","unstructured":"Yu H, Yang Q, Qian Y, et al. A positive correlation between serum lactate dehydrogenase level and in-hospital mortality in ICU sepsis patients: evidence from two large databases. Eur J Med Res. 2024;29:525.","journal-title":"Eur J Med Res"},{"key":"10982_CR5","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.3389\/fimmu.2019.01363","volume":"10","author":"D Cross","year":"2019","unstructured":"Cross D, Drury R, Hill J, et al. Epigenetics in Sepsis: Understanding Its Role in Endothelial Dysfunction, Immunosuppression, and Potential Therapeutics. Front Immunol. 2019;10:1363.","journal-title":"Front Immunol"},{"key":"10982_CR6","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.940779","volume":"13","author":"W Lei","year":"2022","unstructured":"Lei W, Ren Z, Su J, et al. Immunological risk factors for sepsis-associated delirium and mortality in ICU patients. Front Immunol. 2022;13: 940779.","journal-title":"Front Immunol"},{"key":"10982_CR7","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/s13054-016-1208-6","volume":"20","author":"RM Bateman","year":"2016","unstructured":"Bateman RM, Sharpe MD, Jagger JE, et al. 36th International Symposium on Intensive Care and Emergency Medicine : Brussels, Belgium. 15\u201318 March 2016. Crit Care. 2016;20:94.","journal-title":"Crit Care"},{"key":"10982_CR8","doi-asserted-by":"crossref","unstructured":"Yamamoto T, Mizobata Y, Kawazoe Y, et al. Incidence, risk factors, and outcomes for sepsis-associated delirium in patients with mechanical ventilation: A sub-analysis of a multicenter randomized controlled trial. J Crit Care. 2020;56:140\u20134.","DOI":"10.1016\/j.jcrc.2019.12.018"},{"key":"10982_CR9","doi-asserted-by":"crossref","unstructured":"Hong Y, Chen P, Gao J, et al. Sepsis-associated encephalopathy: From pathophysiology to clinical management. Int Immunopharmacol. 2023;124:110800.","DOI":"10.1016\/j.intimp.2023.110800"},{"key":"10982_CR10","doi-asserted-by":"publisher","first-page":"2703","DOI":"10.1001\/jama.286.21.2703","volume":"286","author":"E Ew","year":"2001","unstructured":"Ew E, Sk I, Gr B, et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA. 2001;286:2703\u201310.","journal-title":"JAMA"},{"key":"10982_CR11","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1186\/s13054-024-05204-7","volume":"28","author":"N Schreiber","year":"2024","unstructured":"Schreiber N, Eichlseder M, Orlob S, et al. Sex specific differences in short-term mortality after ICU-delirium. Crit Care. 2024;28:413.","journal-title":"Crit Care"},{"key":"10982_CR12","doi-asserted-by":"crossref","unstructured":"Tokuda R, Nakamura K, Takatani Y, et al. Sepsis-associated delirium: a narrative review. J Clin Med. 2023;12(4):1273.","DOI":"10.3390\/jcm12041273"},{"key":"10982_CR13","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.988293","volume":"13","author":"J Yoo","year":"2022","unstructured":"Yoo J, Joo B, Park J, et al. Delirium-related factors and their prognostic value in patients undergoing craniotomy for brain metastasis. Front Neurol. 2022;13: 988293.","journal-title":"Front Neurol"},{"key":"10982_CR14","doi-asserted-by":"publisher","first-page":"12697","DOI":"10.1038\/s41598-023-38650-4","volume":"13","author":"Y Zhang","year":"2023","unstructured":"Zhang Y, Hu J, Hua T, et al. Development of a machine learning-based prediction model for sepsis-associated delirium in the intensive care unit. Sci Rep. 2023;13:12697.","journal-title":"Sci Rep"},{"key":"10982_CR15","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1186\/s12911-023-02282-5","volume":"23","author":"Q Gu","year":"2023","unstructured":"Gu Q, Yang S, Fei D, et al. A nomogram for predicting sepsis-associated delirium: a retrospective study in MIMIC III. BMC Med Inform Decis Mak. 2023;23:184.","journal-title":"BMC Med Inform Decis Mak"},{"key":"10982_CR16","doi-asserted-by":"crossref","unstructured":"Xie H, Jia Y, Liu S. Integration of artificial intelligence in clinical laboratory medicine: advancements and challenges. Interdiscip Med. 2024;2:e20230056.","DOI":"10.1002\/INMD.20230056"},{"key":"10982_CR17","doi-asserted-by":"crossref","unstructured":"Defilippo A, Bertucci G, Zurzolu C, et al. On the computational approaches for supporting triage systems. Interdiscip Med. 2023;1:e20230015.","DOI":"10.1002\/INMD.20230015"},{"key":"10982_CR18","doi-asserted-by":"crossref","unstructured":"Banerjee S. Generating complex explanations for artificial intelligence models: an application to clinical data on severe mental illness. Life (Basel) 2024;14(7):807.","DOI":"10.3390\/life14070807"},{"key":"10982_CR19","doi-asserted-by":"publisher","first-page":"497","DOI":"10.5582\/bst.2024.01342","volume":"18","author":"K Karako","year":"2025","unstructured":"Karako K, Tang W. Applications of and issues with machine learning in medicine: Bridging the gap with explainable AI. Biosci Trends. 2025;18:497\u2013504.","journal-title":"Biosci Trends"},{"key":"10982_CR20","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1007\/s10238-024-01450-9","volume":"24","author":"A He","year":"2024","unstructured":"He A, Liu J, Qiu J, et al. Risk and mediation analyses of hemoglobin glycation index and survival prognosis in patients with sepsis. Clin Exp Med. 2024;24:183.","journal-title":"Clin Exp Med"},{"key":"10982_CR21","doi-asserted-by":"crossref","unstructured":"Contreras M, Silva B, Shickel B, et al. Dynamic delirium prediction in the intensive care unit using machine learning on electronic health records. IEEE EMBS Int Conf Biomed Health Inform. 2023;2023:10.1109\/bhi58575.2023.10313445.","DOI":"10.1109\/BHI58575.2023.10313445"},{"key":"10982_CR22","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.ccc.2019.08.009","volume":"36","author":"J Bakker","year":"2020","unstructured":"Bakker J, Postelnicu R, Mukherjee V. Lactate: Where Are We Now? Crit Care Clin. 2020;36:115\u201324.","journal-title":"Crit Care Clin"},{"key":"10982_CR23","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1016\/j.cmet.2018.03.008","volume":"27","author":"GA Brooks","year":"2018","unstructured":"Brooks GA. The Science and Translation of Lactate Shuttle Theory. Cell Metab. 2018;27:757\u201385.","journal-title":"Cell Metab"},{"key":"10982_CR24","first-page":"0","volume":"21","author":"Q Xia","year":"2023","unstructured":"Xia Q, Yu-Peng L, Rui-Xi Z. SIRS, SOFA, qSOFA, and NEWS in the diagnosis of sepsis and prediction of adverse outcomes: a systematic review and meta-analysis. Expert Rev Anti Infect Ther. 2023;21:0.","journal-title":"Expert Rev Anti Infect Ther"},{"key":"10982_CR25","doi-asserted-by":"publisher","first-page":"4760","DOI":"10.1038\/s41598-024-55257-5","volume":"14","author":"S Fan","year":"2024","unstructured":"Fan S, Ma J. The value of five scoring systems in predicting the prognosis of patients with sepsis-associated acute respiratory failure. Sci Rep. 2024;14:4760.","journal-title":"Sci Rep"},{"key":"10982_CR26","doi-asserted-by":"publisher","first-page":"e14762","DOI":"10.1111\/cns.14762","volume":"30","author":"H Cheng","year":"2024","unstructured":"Cheng H, Ling Y, Li Q, et al. Association between modified frailty index and postoperative delirium in patients after cardiac surgery: A cohort study of 2080 older adults. CNS Neurosci Ther. 2024;30:e14762.","journal-title":"CNS Neurosci Ther"},{"key":"10982_CR27","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1093\/bmb\/ldz033","volume":"132","author":"E Mitchell","year":"2019","unstructured":"Mitchell E, Pearce MS, Roberts A. Gram-negative bloodstream infections and sepsis: risk factors, screening tools and surveillance. Br Med Bull. 2019;132:5\u201315.","journal-title":"Br Med Bull"},{"key":"10982_CR28","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.jjcc.2020.03.007","volume":"76","author":"J Matsuda","year":"2020","unstructured":"Matsuda J, Kato S, Yano H, et al. The Sequential Organ Failure Assessment (SOFA) score predicts mortality and neurological outcome in patients with post-cardiac arrest syndrome. J Cardiol. 2020;76:295\u2013302.","journal-title":"J Cardiol"},{"key":"10982_CR29","doi-asserted-by":"crossref","unstructured":"Mousabeygi E, Rahmati M, Salari N, et al. Predicting mortality of elderly patients undergoing open heart surgery with delirium using sequential organ failure assessment (SOFA), multi-organ dysfunction (MODS), and logistic organ dysfunction system (LODS) scores. Geriatr Nurs. 2024;60:146\u20139.","DOI":"10.1016\/j.gerinurse.2024.08.023"},{"key":"10982_CR30","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.bja.2022.01.005","volume":"129","author":"J Taylor","year":"2022","unstructured":"Taylor J, Parker M, Casey CP, et al. Postoperative delirium and changes in the blood-brain barrier, neuroinflammation, and cerebrospinal fluid lactate: a prospective cohort study. Br J Anaesth. 2022;129:219\u201330.","journal-title":"Br J Anaesth"},{"key":"10982_CR31","doi-asserted-by":"publisher","first-page":"2820","DOI":"10.1038\/s41598-023-29506-y","volume":"13","author":"D Liu","year":"2023","unstructured":"Liu D, Yao Q, Song B, et al. Serum lactate monitoring may help to predict neurological function impairment caused by acute metabolism crisis. Sci Rep. 2023;13:2820.","journal-title":"Sci Rep"},{"key":"10982_CR32","doi-asserted-by":"crossref","unstructured":"Qian X, Sheng Y, Jiang Y, et al. Associations of serum lactate and lactate clearance with delirium in the early stage of ICU: a retrospective cohort study of the MIMIC-IV database. Front Neurol. 2024;15:1371827.","DOI":"10.3389\/fneur.2024.1371827"},{"key":"10982_CR33","doi-asserted-by":"crossref","unstructured":"Heikal M, Saad H, Ghanime PM, et al. Using machine learning and electronic health records to identify neuropsychiatric risk scores for delirium in ICU and general hospital settings. Neuropsychiatr Dis Treat. 2024;20:1861\u201376.","DOI":"10.2147\/NDT.S479756"},{"key":"10982_CR34","doi-asserted-by":"publisher","first-page":"e0200495","DOI":"10.1371\/journal.pone.0200495","volume":"13","author":"DN Nguyen","year":"2018","unstructured":"Nguyen DN, Huyghens L, Parra J, et al. Hypotension and a positive fluid balance are associated with delirium in patients with shock. PLoS ONE. 2018;13:e0200495.","journal-title":"PLoS ONE"},{"key":"10982_CR35","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1186\/s13054-022-04131-9","volume":"26","author":"H Pang","year":"2022","unstructured":"Pang H, Kumar S, Ely EW, et al. Acute kidney injury-associated delirium: a review of clinical and pathophysiological mechanisms. Crit Care. 2022;26:258.","journal-title":"Crit Care"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-025-10982-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-025-10982-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-025-10982-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T09:47:33Z","timestamp":1745401653000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-025-10982-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,23]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["10982"],"URL":"https:\/\/doi.org\/10.1186\/s12879-025-10982-8","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,23]]},"assertion":[{"value":"20 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. The MIMIC database follows a review board protocol in which all patient personal information is de-identified, using random codes to identify specific patients. The Ethics Committee of Yangzhou University Affiliated North District People's Hospital agreed to exempt this study from informed consent and ethical approval requirements.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"585"}}