Sequential Learning for Sepsis Prediction: LSTM and Transformer Architectures on ICU Time Series Data

Sequential Learning for Sepsis Prediction: LSTM and Transformer Architectures on ICU Time Series Data | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Sequential Learning for Sepsis Prediction: LSTM and Transformer Architectures on ICU Time Series Data morteza jafari nik pey This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7583009/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Early detection of sepsis in ICU patients is critical because timely intervention can reduce mortality and improve clinical outcomes. This study presents a systematic framework for sepsis prediction using time-series data from ICU of over 40,000 patients. The main objective was to evaluate and compare sequential models, including LSTM, BiLSTM, and Transformer architectures, under the challenges of class imbalance and real-world ICU data, while carefully controlling for data leakage to ensure result validity. The models were trained with comprehensive preprocessing, including handling missing values, normalization, and noise reduction, and performance metrics such as precision, recall, F1-score, and AUROC were measured. The results showed that BiLSTM and Transformer architectures provide complementary strengths: BiLSTM achieves a balanced trade-off between precision and recall, whereas transformers better capture long-term temporal dependencies and early warning signals. This study demonstrates that the transition from classical machine learning to deep sequence models is not only a technical advancement but also a clinical necessity for reliable and early sepsis detection. All codes and preprocessing pipelines are publicly available to promote transparency and reproducibility. Sepsis Prediction ICU LSTM Transformer BiLSTM Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7583009","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":538657692,"identity":"4dcd8343-b8e8-4536-8a0e-4387af93db2a","order_by":0,"name":"morteza jafari nik pey","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABFklEQVRIiWNgGAWjYFADZjYQaSPHD6ISCvCqZWxA0pJmLAniJhgQo4UBrOVQ4oYDIBqPFt323ucPPvyxYzBnZ0t78LHtQOLm86sTPzwwYJDnFzuAVYvZmeOGjTN4khksm9mOG85su2O87cbbzRJAhxnOnJ2AXcuNNMZmHglmBoPD7G3SvG3PZLfdOLsBpCXB4DYeLX8M6iFa/rYdZtw84+zmHwS1MCQcBmphOybN2HZYcQN/7zb8tpw5xjiz58BxHqCWdMOec2nGEjd4t1kkGEjg9svxNoYPP/5UyxmcP2b24EcZMCr7z26++aPCRp5fGrsWGOBhAEUMIyhuJMAqJfAqhwGg+j9Aiv8AUapHwSgYBaNg5AAAdMFj0Ptn5z8AAAAASUVORK5CYII=","orcid":"","institution":"","correspondingAuthor":true,"prefix":"","firstName":"morteza","middleName":"jafari nik","lastName":"pey","suffix":""}],"badges":[],"createdAt":"2025-09-10 12:38:34","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7583009/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7583009/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":95526863,"identity":"c7b3d5db-7ff8-4cef-a956-080173343e91","added_by":"auto","created_at":"2025-11-10 10:08:19","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":2109771,"visible":true,"origin":"","legend":"","description":"","filename":"SequentialLearningforSepsisPredictionnew.docx","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/05cf9768eb16b618d9f7154a.docx"},{"id":95408180,"identity":"0c1e3ae1-bcbc-474a-b421-0af5bb62943a","added_by":"auto","created_at":"2025-11-07 17:58:28","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":3758,"visible":true,"origin":"","legend":"","description":"","filename":"ec7e18b961e845feab8ef65577a10b1c.json","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/70bb849cd837f58b25ade83b.json"},{"id":95526933,"identity":"328d88ba-3633-4824-bcc8-1d8cdb5f39fb","added_by":"auto","created_at":"2025-11-10 10:08:42","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":194798,"visible":true,"origin":"","legend":"","description":"","filename":"ec7e18b961e845feab8ef65577a10b1c1enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/934f88f2bbdb6cf2fd7cd039.xml"},{"id":95408175,"identity":"be9f5f06-70f3-44d8-a0eb-80678501e221","added_by":"auto","created_at":"2025-11-07 17:58:28","extension":"jpeg","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1307,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/5ae145e8cccb8c6a7de9fc8c.jpeg"},{"id":95527493,"identity":"d960d714-766d-47eb-aaa9-7abfb42aff05","added_by":"auto","created_at":"2025-11-10 10:13:52","extension":"jpeg","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":83728,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/4a21d58d0e7a4007c50d221f.jpeg"},{"id":95526947,"identity":"77215087-a707-454b-8b55-d49bf49e1347","added_by":"auto","created_at":"2025-11-10 10:08:48","extension":"jpeg","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":77592,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage11.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/49eb57fc07a6c0e55a3dbb42.jpeg"},{"id":95527322,"identity":"725b731c-130e-407f-ba19-e9381df7da15","added_by":"auto","created_at":"2025-11-10 10:13:10","extension":"jpeg","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":64001,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage12.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/e25439e0ebc7d8b35a6de605.jpeg"},{"id":95408177,"identity":"37c7fa89-99fb-4247-884b-3fdecdd8e721","added_by":"auto","created_at":"2025-11-07 17:58:28","extension":"jpeg","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":59047,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage13.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/972ea6210c4d2a7be472ddec.jpeg"},{"id":95526734,"identity":"df284b7f-8e5b-4c06-9064-ab82b728988a","added_by":"auto","created_at":"2025-11-10 10:07:44","extension":"jpeg","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":56097,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage14.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/070be38f50d6515a1e6d9e1c.jpeg"},{"id":95527714,"identity":"9f486993-2810-4bd3-be96-ffb073f489d8","added_by":"auto","created_at":"2025-11-10 10:14:34","extension":"jpeg","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":32381,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage15.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/5eb7d2e5a49a058aa9ffe25a.jpeg"},{"id":95408185,"identity":"2d1fdd6e-8fad-44e0-a09a-c85af4d5139b","added_by":"auto","created_at":"2025-11-07 17:58:28","extension":"jpeg","order_by":10,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":87407,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage16.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/a3611a4f1de6906da5f73582.jpeg"},{"id":95527505,"identity":"c050f7f3-6c2a-495b-9efb-9b943b8c73ef","added_by":"auto","created_at":"2025-11-10 10:13:57","extension":"jpeg","order_by":11,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":453364,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage17.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/37661b4765a74063f67f93b0.jpeg"},{"id":95408191,"identity":"f9a179c1-457e-4d57-8662-7b6025e5f93f","added_by":"auto","created_at":"2025-11-07 17:58:28","extension":"jpeg","order_by":12,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":307961,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage18.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/54eb442953aa995f529f95d2.jpeg"},{"id":95408197,"identity":"8dd6e0e1-487a-4f4d-afc9-6cf17eb9955f","added_by":"auto","created_at":"2025-11-07 17:58:28","extension":"jpeg","order_by":13,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":152165,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/131c03dd577eb60fbb571f94.jpeg"},{"id":95526868,"identity":"e14198d5-d686-414d-8d94-f78c416f9b1b","added_by":"auto","created_at":"2025-11-10 10:08:24","extension":"jpeg","order_by":14,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":33050,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage3.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/3c670aa4eb46052f8b28a031.jpeg"},{"id":95527116,"identity":"79a0662b-3cc3-4a08-a9f1-57fc302b5c75","added_by":"auto","created_at":"2025-11-10 10:11:03","extension":"jpeg","order_by":15,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":76697,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage4.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/9631988bff090807a74e5e54.jpeg"},{"id":95408195,"identity":"ac5bdc10-55c4-462f-854f-39cb9f847cf1","added_by":"auto","created_at":"2025-11-07 17:58:28","extension":"jpeg","order_by":16,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":67296,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage5.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/af462653c9c04bf69bc8bf3a.jpeg"},{"id":95408183,"identity":"35e9ac87-d99c-4133-9e54-8f8a38ee64b4","added_by":"auto","created_at":"2025-11-07 17:58:28","extension":"jpeg","order_by":17,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":35877,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage6.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/4a11384ba62b97d8edca8a58.jpeg"},{"id":95527741,"identity":"2f03f089-8292-4468-bd79-886f96e56f1c","added_by":"auto","created_at":"2025-11-10 10:14:38","extension":"jpeg","order_by":18,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":72772,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage7.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/30ef9ec569e36db560080d73.jpeg"},{"id":95408206,"identity":"b35dc4dd-beae-40e9-b340-d76fe74586f7","added_by":"auto","created_at":"2025-11-07 17:58:29","extension":"jpeg","order_by":19,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":450962,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage8.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/c67397cbc5c9c5c8c77d91b6.jpeg"},{"id":95527305,"identity":"7c03b5b0-38c8-40cb-b40a-b4d32e313206","added_by":"auto","created_at":"2025-11-10 10:13:01","extension":"jpeg","order_by":20,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":67040,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage9.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/a0c0af9db766c4665c0925c7.jpeg"},{"id":95408189,"identity":"5842d381-8b01-483e-9dad-78b0e1fcc412","added_by":"auto","created_at":"2025-11-07 17:58:28","extension":"png","order_by":21,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":948,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/124d230f95c2bf198f24f657.png"},{"id":95526988,"identity":"7314dde0-5665-48a3-8781-8bcbdb6ca010","added_by":"auto","created_at":"2025-11-10 10:09:01","extension":"png","order_by":22,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":25353,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/e52fae207f2afff09dee7fd3.png"},{"id":95408200,"identity":"3849f299-2bbd-488f-92d4-685c3ee6b8ba","added_by":"auto","created_at":"2025-11-07 17:58:29","extension":"png","order_by":23,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":22796,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage11.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/24fa41a6d74c1a945935a11a.png"},{"id":95408202,"identity":"61b78702-430a-451a-9d80-efa344d041ec","added_by":"auto","created_at":"2025-11-07 17:58:29","extension":"png","order_by":24,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":19986,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage12.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/94d63ee0fd072e60957e7719.png"},{"id":95527498,"identity":"237631bd-6c4a-4b05-a4f6-374b3ff12079","added_by":"auto","created_at":"2025-11-10 10:13:53","extension":"png","order_by":25,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15510,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage13.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/c64863531238edcaf5f97143.png"},{"id":95526982,"identity":"05fa0089-d340-4c55-bd32-e180ee24e106","added_by":"auto","created_at":"2025-11-10 10:08:57","extension":"png","order_by":26,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":16010,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage14.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/cd5adc894df0d64fb23d43f9.png"},{"id":95408199,"identity":"2dc119ff-86a7-40ed-b787-84ca044b404a","added_by":"auto","created_at":"2025-11-07 17:58:28","extension":"png","order_by":27,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":8524,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage15.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/1a9079108db806fb1cfb7c29.png"},{"id":95408204,"identity":"958868a9-88ac-48e0-91c4-604d1893bd8c","added_by":"auto","created_at":"2025-11-07 17:58:29","extension":"png","order_by":28,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":25335,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage16.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/3077a90224e44e518e982b69.png"},{"id":95408203,"identity":"610abf4a-c1cd-433f-b4d2-a3b934976cab","added_by":"auto","created_at":"2025-11-07 17:58:29","extension":"png","order_by":29,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":96865,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage17.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/5a759489eff92cf3cfe81557.png"},{"id":95408208,"identity":"d08dbb14-3b0e-499b-9c43-dc595aaf3852","added_by":"auto","created_at":"2025-11-07 17:58:29","extension":"png","order_by":30,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":66738,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage18.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/17634e6a176c6bf33e3db54d.png"},{"id":95408215,"identity":"acfa39b3-59ca-4283-ba9d-10d82c8439fb","added_by":"auto","created_at":"2025-11-07 17:58:29","extension":"png","order_by":31,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":29454,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/ba3fa83320acab2c56057398.png"},{"id":95408205,"identity":"cffe5fc9-b392-46ce-a047-4ea058fe37c1","added_by":"auto","created_at":"2025-11-07 17:58:29","extension":"png","order_by":32,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":31519,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/8d11db470692d75c0a3c389a.png"},{"id":95408201,"identity":"4c12588f-3883-41a3-9f96-564e4bb79e28","added_by":"auto","created_at":"2025-11-07 17:58:29","extension":"png","order_by":33,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":28899,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/73320a49a586c99bf9b1b4c8.png"},{"id":95527351,"identity":"816c7b0e-af51-4a9c-be1a-c7d6f41720c1","added_by":"auto","created_at":"2025-11-10 10:13:21","extension":"png","order_by":34,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":28701,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/f84e83d1d65e9bfe272d2cad.png"},{"id":95408207,"identity":"6d98b011-32e7-42f5-bf35-8b3ac0b0837a","added_by":"auto","created_at":"2025-11-07 17:58:29","extension":"png","order_by":35,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":17290,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage6.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/c8dc93188ea5f47f1a4d8f19.png"},{"id":95408214,"identity":"767a3dc6-dee8-4cf2-9c3f-deeed78428f6","added_by":"auto","created_at":"2025-11-07 17:58:29","extension":"png","order_by":36,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":20314,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage7.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/af92b5d9efa80d9e18f91e68.png"},{"id":95526709,"identity":"510652ed-32e7-4f4e-8212-8c73e20ed8f4","added_by":"auto","created_at":"2025-11-10 10:07:38","extension":"png","order_by":37,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":113311,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage8.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/2a931e291b4114120f5fbbb1.png"},{"id":95408209,"identity":"260b2d33-b695-451b-81bd-0320244573f7","added_by":"auto","created_at":"2025-11-07 17:58:29","extension":"png","order_by":38,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":20104,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage9.png","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/ae2dfaf6bbde96c2e7a5708e.png"},{"id":95526744,"identity":"9093f1c1-cbf1-4dc3-a74b-2666f27e4bd1","added_by":"auto","created_at":"2025-11-10 10:07:46","extension":"xml","order_by":39,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":191847,"visible":true,"origin":"","legend":"","description":"","filename":"ec7e18b961e845feab8ef65577a10b1c1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/1bb9f1075342464e33fd6655.xml"},{"id":95408212,"identity":"af5b9725-7da4-4916-8478-7de0d0d21f95","added_by":"auto","created_at":"2025-11-07 17:58:29","extension":"html","order_by":40,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":210736,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1/0f3f630b227530ee74e40ed8.html"},{"id":98492050,"identity":"17b1b9d6-09d5-4b0e-bb6f-b3f82fdc7bc3","added_by":"auto","created_at":"2025-12-18 08:10:17","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1079897,"visible":true,"origin":"","legend":"","description":"","filename":"SequentialLearningforSepsisPredictionnew.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7583009/v1_covered_4b33decd-b8f0-493d-8e83-56806d089faa.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Sequential Learning for Sepsis Prediction: LSTM and Transformer Architectures on ICU Time Series Data","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Sepsis Prediction, ICU, LSTM, Transformer, BiLSTM","lastPublishedDoi":"10.21203/rs.3.rs-7583009/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7583009/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eEarly detection of sepsis in ICU patients is critical because timely intervention can reduce mortality and improve clinical outcomes. This study presents a systematic framework for sepsis prediction using time-series data from ICU of over 40,000 patients. The main objective was to evaluate and compare sequential models, including LSTM, BiLSTM, and Transformer architectures, under the challenges of class imbalance and real-world ICU data, while carefully controlling for data leakage to ensure result validity.\u003c/p\u003e\n\u003cp\u003eThe models were trained with comprehensive preprocessing, including handling missing values, normalization, and noise reduction, and performance metrics such as precision, recall, F1-score, and AUROC were measured. The results showed that BiLSTM and Transformer architectures provide complementary strengths: BiLSTM achieves a balanced trade-off between precision and recall, whereas transformers better capture long-term temporal dependencies and early warning signals.\u003c/p\u003e\n\u003cp\u003eThis study demonstrates that the transition from classical machine learning to deep sequence models is not only a technical advancement but also a clinical necessity for reliable and early sepsis detection. All codes and preprocessing pipelines are publicly available to promote transparency and reproducibility.\u003c/p\u003e","manuscriptTitle":"Sequential Learning for Sepsis Prediction: LSTM and Transformer Architectures on ICU Time Series Data","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-07 17:58:23","doi":"10.21203/rs.3.rs-7583009/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2dfd7e0c-a545-471c-b24e-0f7e63cf2e37","owner":[],"postedDate":"November 7th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-18T08:10:03+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-07 17:58:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7583009","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7583009","identity":"rs-7583009","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}