NutriSighT: Interpretable Transformer Model for Dynamic Prediction of Underfeeding Enteral Nutrition in Mechanically Ventilated Patients
Achieving adequate enteral nutrition among mechanically ventilated patients is challenging, yet critical. We develop NutriSighT, a transformer model using learnable positional encodings to predict which patients would be underfed (receive less than 70% daily caloric requirements) between days 3-7 of mechanical ventilation and compared its performance against XGBoost. Using retrospective data from two ICU databases (3284 patients from AmsterdamUMCdb for development and 6456 from MIMIC-IV for external validation), we included adults mechanically ventilated for at least 72 h. NutriSighT achieved AUROC of 0.81 (95% CI: 0.81 - 0.82) and AUPRC of 0.70 (95% CI: 0.70 - 0.72) internally. External validation yielded AUROC of 0.76 (95% CI: 0.75 - 0.76) and an AUPRC of 0.70 (95% CI: 0.69 - 0.70). In comparison, XGBoost achieved AUROC of 0.58 (95% CI: 0.58 - 0.59) and AUPRC of 0.48 (95% CI: 0.46 - 0.50). This approach may help clinicians personalize nutritional therapy in critical care.
Authors
- Jayshil J. Patel (ORCID: https://orcid.org/0000-0003-0663-7670)
- Jacob Desman (ORCID: https://orcid.org/0000-0002-5411-6637)
- Paul McCarthy (ORCID: https://orcid.org/0000-0002-4896-8374)
- Nidhi Kavi
- Eyal Klang (ORCID: https://orcid.org/0000-0002-4567-3108)
- Akhil Vaid (ORCID: https://orcid.org/0000-0002-3343-744X)
- Dhruv Patel (ORCID: https://orcid.org/0000-0003-3957-8822)
- Girish N. Nadkarni (ORCID: https://orcid.org/0000-0001-6319-4314)
- Lili Chan (ORCID: https://orcid.org/0000-0003-4300-5760)
- Jaskirat Gill
- Rohit Gupta (ORCID: https://orcid.org/0000-0002-4436-8275)
- Robert Freeman (ORCID: https://orcid.org/0000-0003-4946-6533)
- Mayte Suárez‐Fariñas (ORCID: https://orcid.org/0000-0001-8712-3553)
- Ankit Sakhuja (ORCID: https://orcid.org/0000-0002-2045-518X)
- Roopa Kohli‐Seth (ORCID: https://orcid.org/0000-0002-6082-1359)
- Anthony Manasia
- Alexander W. Charney (ORCID: https://orcid.org/0000-0001-8135-6858)
- Mateen Jangda (ORCID: https://orcid.org/0009-0005-8692-8508)
- John Oropello (ORCID: https://orcid.org/0000-0003-4467-3584)
- S Bakare
Institutions
- West Virginia University (US)
- Medical College of Wisconsin (US)
- Icahn School of Medicine at Mount Sinai (US)
Publication Details
- Journal
- Nature Communications
- Published
- 2025-12-17
- DOI
- https://doi.org/10.1038/s41467-025-66200-1
- Primary Topic
- Clinical Nutrition and Gastroenterology
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Institutes of Health