What's in a Definition? A simulation Framework for Modeling sepsis Interventions using Electronic Health Records.

Sepsis, the body's inflammatory response to infection, is a serious complication and leading cause of in-hospital mortality. Timely intervention is both difficult and critical since sepsis can rapidly worsen to organ dysfunction and septic shock. However, the lack of a gold-standard definition renders the lines between these transitions unclear, complicating medical decision-making. Using electronic health records, we build a simulation framework to study the evolution of dynamic physiological and cellular responses to therapeutic interventions in septic patients. Since sepsis trajectories can manifest differently depending on patient characteristics, we incorporate patient heterogeneity through comorbidity, age, race, and gender. Under therapeutic interventions recommended by the Centers for Medicare and Medicaid Services (CMS), we illustrate the framework on patient trajectories using the CMS criteria for sepsis definition. The framework is designed to support the comparison and quantification of the impact of clinical definitions and recommended interventions on the timely identification of sepsis states.