Development of a new prognostic model to predict pneumonia outcome using artificial intelligence-based chest radiograph results.

Journal: Scientific reports
PMID:

Abstract

This study aimed to develop a new simple and effective prognostic model using artificial intelligence (AI)-based chest radiograph (CXR) results to predict the outcomes of pneumonia. Patients aged > 18 years, admitted the treatment of pneumonia between March 2020 and August 2021 were included. We developed prognostic models, including an AI-based consolidation score in addition to the conventional CURB-65 (confusion, urea, respiratory rate, blood pressure, and age ≥ 65) and pneumonia severity index (PSI) for predicting pneumonia outcomes, defined as 30-day mortality during admission. A total of 489 patients, including 310 and 179 patients in training and test sets, were included. In the training set, the AI-based consolidation score on CXR was a significant variable for predicting the outcome (hazard ratio 1.016, 95% confidence interval [CI] 1.001-1.031). The model that combined CURB-65, initial O requirement, intubation, and the AI-based consolidation score showed a significantly high C-index of 0.692 (95% CI 0.628-0.757) compared to other models. In the test set, this model also demonstrated a significantly high C-index of 0.726 (95% CI 0.644-0.809) compared to the conventional CURB-65 and PSI (p < 0.001 and 0.017, respectively). Therefore, a new prognostic model incorporating AI-based CXR results along with traditional pneumonia severity score could be a simple and useful tool for predicting pneumonia outcomes in clinical practice.

Authors

  • Hyun Joo Shin
    Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Korea. lamer-22@yuhs.ac.
  • Eun Hye Lee
    Department of Radiology, Soonchunhyang University Hospital Bucheon, Soonchunhyang University College of Medicine, Bucheon, South Korea.
  • Kyunghwa Han
    From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea (S.H.P.); and Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea (K.H.).
  • Leeha Ryu
    Department of Biostatistics and Computing, Yonsei University Graduate School, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea.
  • Eun-Kyung Kim
    Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.