Artificial intelligence for improved decision-making in diabetic emergency survival: A cross-sectional study.

• The Random Forest model accurately predicted survival in diabetic emergency patients, achieving an AUC of 0.96 • Patients categorized under immediate triage (P1) had significantly better survival outcomes • Integrating AI-driven predictive tools into emergency nursing workflows may enhance triage...

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Published in:International Emergency Nursing Vol. 83
Main Authors: Nikentari, Lintang Arum, Kristianto, Heri, Yuliatun, Laily, Haedar, Ali, Tirma Irawan, Paulus Lucky
Format: research Journal Article
Published: Elsevier B.V. Dec2025
Online Access:View this record in EBSCOhost
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      dt: Dec2025
      vid: 83
      pid: 467
      pub: Elsevier B.V.
      place: New York, New York
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        189517824
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        10.1016/j.ienj.2025.101700
        189517824
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        atl: Artificial intelligence for improved decision-making in diabetic emergency survival: A cross-sectional study.
      aug:
        au:
          Nikentari, Lintang Arum
          Kristianto, Heri
          Yuliatun, Laily
          Haedar, Ali
          Tirma Irawan, Paulus Lucky
        affil: Nursing Department, Faculty of Health Sciences, Brawijaya University, Malang, Indonesia
      sug:
        subj:
          Artificial Intelligence
          Decision Making, Clinical
          Diabetes Mellitus Mortality
          Mortality Risk Factors
          Emergency Service
          Prediction Models Evaluation
          Overall Survival
          Human
          Indonesia
          Retrospective Design
          Cross Sectional Studies
          Record Review
          Logistic Regression
          ROC Curve
          Glasgow Coma Scale
          Random Forest
          Algorithms
          Triage
          Emergency Nursing
          Emergency Nurses Psychosocial Factors
          Workflow
          Blood Glucose
          Insulin
          Resource Allocation
          Validation Studies
      ab: • The Random Forest model accurately predicted survival in diabetic emergency patients, achieving an AUC of 0.96 • Patients categorized under immediate triage (P1) had significantly better survival outcomes • Integrating AI-driven predictive tools into emergency nursing workflows may enhance triage accuracy This study aims to develop and validate an artificial intelligence -driven survival prediction model using the Random Forest algorithm to support clinical decision-making in diabetic emergency cases. The model is designed to assist emergency nurses in triage prioritization and resource allocation to improve patient outcomes. A retrospective cross-sectional study was conducted using medical records of 1,047 diabetic emergency patients treated at regional hospital in Indonesia, from 2019 to 2024. Key clinical variables, including age, gender, blood glucose levels, Glasgow Coma Scale, triage classification, and insulin use, were analyzed. Logistic regression identified significant survival predictors, and random forest model was developed for survival prediction. Model performance was evaluated using accuracy, sensitivity, specificity, and the area under the receiver operating characteristic AUC (Area Under Curve). The random forest model identified GCS and triage classification as the most significant predictors of survival. Patients with higher GCS scores and immediate triage classification (P1) had a greater likelihood of survival. The model demonstrated high predictive performance, achieving an accuracy of 94.9 %, sensitivity of 95.6 %, specificity of 93.7 %, and an AUC of 0.96. The AI-based random forest model demonstrated excellent predictive accuracy, supporting its integration into emergency nursing workflows. Implementing AI-driven decision-support systems in emergency departments may enhance triage accuracy, to improve survival outcomes in diabetic emergencies, future studies should focus on external validation and the integration of additional clinical parameters to further refine model performance.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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