Early Sepsis Detection Using Heterogeneous Structured ICU Data with Explainable Deep Learning

Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection, making early detection critical for improving outcomes in intensive care units (ICUs). This study presents a retrospective comparative evaluation of deep learning architectures for predicting sepsis up to 6 h before the PhysioNet/Computing in Cardiology 2019 Challenge onset label using hourly structured electronic health record (EHR) variables, including vital signs, laboratory measurements, and demographics. Evaluated architectures include Convolutional Neural Network (CNN), Long Short-Term Memory (LSTM), Gated Recurrent Unit (GRU), Bidirectional Long Short-Term Memory (Bi-LSTM), Temporal Convolutional Network (TCN), Transformer, and hybrid Convolutional Neural Network–Vision Transformer (CNN-ViT) models. Median imputation and class-weighted loss were applied to address missing values and severe class imbalance, while Shapley Additive Explanations (SHAP) and attention analyses were used as complementary interpretability approaches. Among the evaluated models, CNN-ViT achieved the strongest overall minority-class performance, with 88.25% accuracy, 0.7480 recall, a 0.454 F1-score, and a 0.48 area under the precision–recall curve (AUPRC), although the numerical gains over other advanced temporal and hybrid architectures were modest. Leave-one-unit-out evaluation further demonstrated relatively stable performance under internal distribution shifts. The results suggest that combining local feature extraction with temporal and attention-based modeling can improve early sepsis prediction from structured ICU data. However, the study represents a retrospective computational benchmark using a public dataset and does not constitute prospective clinical validation or real-world deployment assessment.