NPCNet: Navigator-Driven Pseudo Text for Deep Clustering of Early Sepsis Phenotyping

Abstract: Sepsis is a heterogeneous syndrome. Identifying clinically distinct phenotypes may enable more precise treatment strategies. In recent years, many researchers have applied clustering algorithms to sepsis patients. However, the clustering process rarely incorporates clinical relevance, potentially limiting to reflect clinically distinct phenotypes. We propose NPCNet, a novel deep clustering network with a target navigator that integrates temporal Electronic Health Records (EHRs) to better align sepsis phenotypes with clinical significance. We identify four sepsis phenotypes ($α$, $β$, $γ$, and $δ$) with divergence in SOFA trajectories. Notably, while $α$ and $δ$ phenotypes both show severe conditions in the early stage, NPCNet effectively differentiates patients who are likely to improve ($α$) from those at risk of deterioration ($δ$). Furthermore, through the treatment effect analysis, we discover that $α$, $β$, and $δ$ phenotypes may benefit from early vasopressor administration. The results show that NPCNet enhances precision treatment strategies by uncovering clinically distinct phenotypes.