AI-Driven Predictive Models for Early Detection of Pediatric Sepsis: A Systematic Review and Meta-Analysis
Abstract
Background Pediatric sepsis continues to pose a major challenge in healthcare, compounded by delayed diagnosis and treatment resulting in poor outcomes. Artificial intelligence (AI) and machine learning (ML) continue to develop predictive models that can support the early identification of pediatric sepsis and assist with better patient outcomes. Objective This systematic review and meta-analysis evaluated AI-driven predictive models for identifying early pediatric sepsis and evaluated diagnostic accuracy, performance metrics, and clinical readiness. Methods Following PRISMA guidelines and registered in PROSPERO (CRD420251244587), we searched PubMed, Google Scholar, Cochrane, and Scopus for studies on AI models predicting pediatric sepsis. AUROC (Area Under the Receiver Operating Characteristic Curve) was the major performance metric, along with sensitivity, specificity, and accuracy. For statistical analysis, AUROC values were converted into Cohen’s d to measure effect size, and upper and lower confidence intervals were determined. A forest plot was then generated, confirming the AI models’ strong predictive performance with statistically significant results. Results This review contains 14 studies with a total of 96,764,476 pediatric patients. AI models improved the accuracy and the ease of detecting sepsis [average AUROC = 0.868 (86.8%)]. ML models were accurate for predicting and detecting sepsis, especially when real-time vital signs, laboratory tests and waveform data were analyzed together, which increased specificity and reliability of early detection. Conclusion AI models are superior to traditional clinical scoring systems in early detection of pediatric sepsis. Nevertheless, the field needs to overcome challenges with data heterogeneity, model interpretability, and clinical adoption. Future work should prioritize validation outside of the original data set, federated learning, and explanations of AI to improve their usability in clinical practice.
Keywords: Pediatric sepsis, artificial intelligence, machine learning, predictive analytics
Keywords:
Pediatric sepsis, artificial intelligence , machine learning , predictive analyticsDOI
https://doi.org/10.22270/jddt.v16i8.7909References
1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (SEpsis-3). JAMA. 2016 Feb 23;315(8):801. Available from: https://doi.org/10.1001/jama.2016.0287
2. Aslan AT, Permana B, Harris PNA, Naidoo KD, Pienaar MA, Irwin AD. The opportunities and challenges for artificial intelligence to improve sepsis outcomes in the Paediatric Intensive Care Unit. Current Infectious Disease Reports. 2023 Oct 31;25(11):243–53. Available from: https://doi.org/10.1007/s11908-023-00818-4
3. Guo L, Han W, Su Y, Wang N, Chen X, Ma J, et al. Perinatal risk factors for neonatal early-onset sepsis: a meta-analysis of observational studies. The Journal of Maternal-Fetal & Neonatal Medicine. 2023 Sep 24;36(2):2259049. Available from: https://doi.org/10.1080/14767058.2023.2259049
4. El-Aziz RMA, Rayan A. Early detection of sepsis using machine learning algorithms. Alexandria Engineering Journal. 2024 Oct 19;111:47–56. Available from: https://doi.org/10.1016/j.aej.2024.10.005
5. Wang H, Zhang R, Xu J, Zhang M, Ren X, Wu Y. Development of a prognosis prediction model for pediatric sepsis based on the NLPR. Journal of Inflammation Research. 2024 Oct 1;Volume 17:7777–91. Available from: https://doi.org/10.2147/jir.s479660
6. Huang C, Chen J, Zhan X, Li L, An S, Cai G, et al. Clinical value of laboratory biomarkers for the diagnosis and early identification of Culture-Positive sepsis in neonates. Journal of Inflammation Research. 2023 Nov 1;Volume 16:5111–24. Available from: https://doi.org/10.2147/jir.s419221
7. Li T, Li X, Liu X, Zhu Z, Zhang M, Xu Z, et al. Association of Procalcitonin to Albumin Ratio with the Presence and Severity of Sepsis in Neonates. Journal of Inflammation Research. 2022 Apr 1;Volume 15:2313–21. https://doi.org/10.2147/jir.s358067
8. Xia Y, Long H, Lai Q, Zhou Y. Machine Learning Predictive Model for Septic Shock in Acute Pancreatitis with Sepsis. Journal of Inflammation Research. 2024 Mar 1;Volume 17:1443–52. Available from: https://doi.org/10.2147/jir.s441591
9. Yang J, Hao S, Huang J, Chen T, Liu R, Zhang P, et al. The application of artificial intelligence in the management of sepsis. Medical Review. 2023 Oct 1;3(5):369–80. Available from: https://doi.org/10.1515/mr-2023-0039
10. Di Sarno L, Caroselli A, Tonin G, Graglia B, Pansini V, Causio FA, et al. Artificial intelligence in Pediatric Emergency Medicine: applications, challenges, and future perspectives. Biomedicines. 2024 May 30;12(6):1220. Available from: https://doi.org/10.3390/biomedicines12061220
11. Wang B, Wang QM, Li DX. An analysis of predictive factors for severe neonatal infection and the construction of a prediction model. Infection and Drug Resistance. 2023 Jun 1;Volume 16:3561–74. http://dx.doi.org/10.2147/idr.s408126
12. Zhu Y, Li X, Guo P, Chen Y, Li J, Tao T.
The accuracy assessment of presepsin (sCD14-ST) for mortality prediction in adult patients with sepsis and a head-to-head comparison to PCT: a meta-analysis
Therapeutics and Clinical Risk Management. 2019 Jun 1;Volume 15:741–53. https://doi.org/10.2147/tcrm.s19873513. Yuan KC, Tsai LW, Lee KH, Cheng YW, Hsu SC, Lo YS, et al. The development an artificial intelligence algorithm for early sepsis diagnosis in the intensive care unit. International Journal of Medical Informatics. 2020 May 21;141:104176. Available from: https://doi.org/10.1016/j.ijmedinf.2020.104176
14. Zhao Y, Zhu R, Hu X. Diagnostic capacity of miRNAs in neonatal sepsis: a systematic review and meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine. 2024 Jan 2;37(1):2345850. https://doi.org/10.1080/14767058.2024.2345850
15. Llitjos JF, Carrol ED, Osuchowski MF, Bonneville M, Scicluna BP, Payen D, et al. Enhancing sepsis biomarker development: key considerations from public and private perspectives. Critical Care. 2024 Jul 13;28(1):238. Available from: https://doi.org/10.1186/s13054-024-05032-9
16. Li F, Wang S, Gao Z, Qing M, Pan S, Liu Y, et al. Harnessing artificial intelligence in sepsis care: advances in early detection, personalized treatment, and real-time monitoring. Frontiers in Medicine. 2025 Jan 6;11:1510792. Available from: https://doi.org/10.3389/fmed.2024.1510792
17. Lee JW, Lee B, Park JD. Pediatric septic shock estimation using deep learning and electronic medical records. Acute and Critical Care. 2024 Aug 1;39(3):400–7. Available from: https://doi.org/10.4266/acc.2024.00031
18. Le S, Hoffman J, Barton C, Fitzgerald JC, Allen A, Pellegrini E, et al. Pediatric Severe sepsis prediction using Machine learning. Frontiers in Pediatrics. 2019 Oct 11;7:413. Available from: https://doi.org/10.3389/fped.2019.00413
19. Mani S, Ozdas A, Aliferis C, Varol HA, Chen Q, Carnevale R, et al. Medical decision support using machine learning for early detection of late-onset neonatal sepsis. Journal of the American Medical Informatics Association. 2013 Sep 17;21(2):326–36. Available from: https://doi.org/10.1136/amiajnl-2013-001854
20. Peng Z, Varisco G, Long X, Liang RH, Kommers D, Cottaar W, et al. A Continuous Late-Onset sepsis prediction algorithm for preterm infants using Multi-Channel physiological signals from a patient monitor. IEEE Journal of Biomedical and Health Informatics. 2022 3;27(1):550–61. https://doi.org/10.1109/jbhi.2022.3216055
21. Kausch SL, Brandberg JG, Qiu J, Panda A, Binai A, Isler J, et al. Cardiorespiratory signature of neonatal sepsis: development and validation of prediction models in 3 NICUs. Pediatric Research. 2023 Jan 2;93(7):1913–21. Available from: https://doi.org/10.1038/s41390-022-02444-7
22. Honoré A, Forsberg D, Adolphson K, Chatterjee S, Jost K, Herlenius E. Vital sign‐based detection of sepsis in neonates using machine learning. Acta Paediatrica. 2023 Jan 6;112(4):686–96. Available from: https://doi.org/10.1111/apa.16660
23. Chiu IM, Cheng CY, Zeng WH, Huang YH, Lin CHR. Using machine learning to predict invasive bacterial infections in young febrile infants visiting the emergency department. Journal of Clinical Medicine. 2021 Apr 26;10(9):1875. Available from: https://doi.org/10.3390/jcm10091875
24. Xiang L, Wang H, Fan S, Zhang W, Lu H, Dong B, et al. Machine learning for early warning of septic shock in children with hematological malignancies accompanied by fever or neutropenia: a Single Center retrospective study. Frontiers in Oncology. 2021 Jun 15;11:678743. https://doi.org/10.3389/fonc.2021.678743
25. Nguyen TM, Poh KL, Chong SL, Lee JH. Effective diagnosis of sepsis in critically ill children using probabilistic graphical model. Translational Pediatrics. 2023 Apr 1;12(4):538–51. Available from: http://dx.doi.org/10.21037/tp-22-510
26. Cabrera-Quiros L, Kommers D, Wolvers MK, Oosterwijk L, Arents N, Van Der Sluijs-Bens J, et al. Prediction of Late-Onset sepsis in preterm infants using monitoring signals and machine learning. Critical Care Explorations. 2021 Jan 1;3(1):e0302. Available from: https://doi.org/10.1097/cce.0000000000000302
27. Masino AJ, Harris MC, Forsyth D, Ostapenko S, Srinivasan L, Bonafide CP, et al. Machine learning models for early sepsis recognition in the neonatal intensive care unit using readily available electronic health record data. PLoS ONE. 2019 Feb 22;14(2):e0212665. https://doi.org/10.1371/journal.pone.0212665
28. Van Den Berg M, Medina O, Loohuis I, Van Der Flier M, Dudink J, Benders M, et al. Development and clinical impact assessment of a machine-learning model for early prediction of late-onset sepsis. Computers in Biology and Medicine. 2023 Jun 15;163:107156. https://doi.org/10.1016/j.compbiomed.2023.107156
29. Velez T, Wang T, Koutroulis I, Chamberlain J, Uppal A, Yohannes S, et al. Identification of Pediatric sepsis subphenotypes for Enhanced Machine Learning Predictive Performance: A Latent Profile analysis. arXiv (Cornell University). 2019 Aug 23; Available from: http://arxiv.org/abs/1908.09038
30. Tabaie A, Orenstein EW, Nemati S, Basu RK, Clifford GD, Kamaleswaran R. Deep learning model to predict serious infection among children with central venous lines. Frontiers in Pediatrics. 2021 15;9:726870. https://doi.org/10.3389/fped.2021.726870
31. Fu S, Li F, Qian SY. Artificial intelligence in pediatric intensive care units: current applications in sepsis management. World Journal of Pediatrics. 2026 May 1;22(5):501–10. Available from: https://doi.org/10.1007/s12519-026-01052-3
32. Branda F, Scarpa F. Implications of artificial intelligence in addressing antimicrobial resistance: innovations, global challenges, and healthcare’s future. Antibiotics. 2024 May 29;13(6):502. https://doi.org/10.3390/antibiotics13060502
33. Nagori A, Gautam A, Wiens MO, Nguyen V, Mugisha NK, Kabakyenga J, et al. Contextual phenotyping of pediatric sepsis cohort using large language models. arXiv (Cornell University). 2025 May 14; Available from: http://arxiv.org/abs/2505.09805
34. Lauritsen SM, Kalør ME, Kongsgaard EL, Lauritsen KM, Jørgensen MJ, Lange J, et al. Early detection of sepsis utilizing deep learning on electronic health record event sequences. arXiv (Cornell University). 2019 Jun 7; http://arxiv.org/abs/1906.02956
35. Mitra A, Ashraf K. Sepsis prediction and vital signs ranking in intensive care unit patients. arXiv (Cornell University). 2018 Dec 17; Available from: http://arxiv.org/abs/1812.06686
36. Tiewei L, Xiaojuan L, Xinrui L, Zhiwei Z, Min Z, Zhe X, et al. Association of procalcitonin-to-albumin ratio with the presence and severity of sepsis in neonates. J Inflamm Res. 2022;2313-21. DOI: 10.2147/JIR.S358067
37. Bedoya AD, Futoma J, Clement ME, Corey K, Brajer N, Lin A, et al. Machine learning for early detection of sepsis: an internal and temporal validation study. JAMIA Open. 2020 Apr 11;3(2):252–60. Available from: https://doi.org/10.1093/jamiaopen/ooaa006
38. Moor M, Bennet N, Plecko D, Horn M, Rieck B, Meinshausen N, et al. Predicting sepsis in multi-site, multi-national intensive care cohorts using deep learning. arXiv (Cornell University). 2021 Jul 12; Available from: http://arxiv.org/abs/2107.05230
39. Meeus M, Beirnaert C, Mahieu L, Laukens K, Meysman P, Mulder A, et al. Clinical decision support for improved neonatal care: The development of a machine learning model for the prediction of late-onset sepsis and necrotizing enterocolitis. The Journal of Pediatrics. 2023 Dec 6;266:113869. Available from: https://doi.org/10.1016/j.jpeds.2023.113869
40. Islam KR, Prithula J, Kumar J, Tan TL, Reaz MBI, Sumon MdSI, et al. Machine learning-based early prediction of sepsis using electronic health records: A systematic review. J Clin Med. 2023;12(17):5658. DOI: 10.3390/jcm12175658
41. Guo L, Han W, Su Y, Wang N, Chen X, Ma J, et al. Perinatal risk factors for neonatal early-onset sepsis: A meta-analysis of observational studies. J Matern-Fetal Neonatal Med. 2023;36(2):2259049. DOI: 10.1080/14767058.2023.2259049
42. Xiao Y, Zhang G. Predictive value of a diagnostic Five-Gene biomarker for pediatric sepsis. Journal of Inflammation Research. 2024;17:2063–71. : https://doi.org/10.2147/jir.s447588
43. Finzel B. Current methods in explainable artificial intelligence and future prospects for integrative physiology. Pflügers Archiv - European Journal of Physiology. 2025 Feb 25;477(4):513–29. Available from: https://doi.org/10.1007/s00424-025-03067-7
44. Li Z, Huang B, Yi W, Wang F, Wei S, Yan H, et al. Identification of potential early diagnostic biomarkers of sepsis. Journal of Inflammation Research. 2021 Mar 1;Volume 14:621–31. Available from: https://doi.org/10.2147/jir.s298604
45. Larsen GY, Brilli R, Macias CG, Niedner M, Auletta JJ, Balamuth F, et al. Development of a quality improvement learning collaborative to improve pediatric sepsis outcomes. PEDIATRICS. 2020 Dec 16;147(1). Available from: https://doi.org/10.1542/peds.2020-1434
46. Górriz JM, Álvarez-Illán I, Álvarez-Marquina A, Arco JE, Atzmueller M, Ballarini F, et al. Computational approaches to Explainable Artificial Intelligence: Advances in theory, applications and trends. Information Fusion. 2023 Jul 29;100:101945. Available from: https://doi.org/10.1016/j.inffus.2023.101945
47. Scipion CEA, Manchester MA, Federman A, Wang Y, Arias JJ. Barriers to and facilitators of clinician acceptance and use of artificial intelligence in healthcare settings: a scoping review. BMJ Open. 2025 Apr 1;15(4):e092624. Available from: https://doi.org/10.1136/bmjopen-2024-092624
48. Shashikumar SP, Mohammadi S, Krishnamoorthy R, Patel A, Wardi G, Ahn JC, et al. Development and prospective implementation of a large language model based system for early sepsis prediction. Npj Digital Medicine. 2025 May 16;8(1):290. Available from: https://doi.org/10.1038/s41746-025-01689-w
49. O’Reilly D, McGrath J, Martin-Loeches I. Optimizing artificial intelligence in sepsis management: Opportunities in the present and looking closely to the future. Journal of Intensive Medicine. 2023 Nov 29;4(1):34–45. Available from: https://doi.org/10.1016/j.jointm.2023.10.001
50. Gomes S, Dhanoa H, Assheton P, Carr E, Roland D, Deep A. Predicting sepsis treatment decisions in the paediatric emergency department using machine learning: the AiSEPTRON study. BMJ Paediatrics Open. 2025 May 1;9(1):e003273. Available from: https://doi.org/10.1136/bmjpo-2024-003273
51. Culliton P, Levinson M, Ehresman A, Wherry J, Steingrub JS, Gallant S I. Predicting Severe Sepsis Using Text from the Electronic Health Record. arXiv (Cornell University). 2017 Nov 30; Available from: http://arxiv.org/abs/1711.11536
52. Song W, Jung SY, Baek H, Choi CW, Jung YH, Yoo S. A Predictive model based on machine learning for the early detection of Late-Onset neonatal sepsis: Development and Observational study. JMIR Medical Informatics. 2020 Jun 7;8(7):e15965. Available from: https://doi.org/10.2196/15965
53. Szakmany T, Fitzgerald E, Garlant HN, Whitehouse T, Molnar T, Shah S, et al. The ‘analysis of gene expression and biomarkers for point-of-care decision support in Sepsis‘ study; temporal clinical parameter analysis and validation of early diagnostic biomarker signatures for severe inflammation andsepsis-SIRS discrimination. Frontiers in Immunology. 2024 Jan 25;14:1308530. Available from: https://doi.org/10.3389/fimmu.2023.1308530
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Copyright (c) 2026 Achsa Sharon Shibu, J. Aadhira , S. Mitra , Marzuq U A Muhammd , P. Nickson , K. Dhivya

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