Low-Dose Computed Tomography Scan Features Are Associated With Annual Risk of Hospitalization

The objective of this study was to investigate whether lung cancer screening low-dose computed tomography (LDCT) can be used to identify features associated with increased risk of hospitalization during the subsequent year.

Patients who underwent lung cancer screening between 2015 and 2020 with at least 1-year follow-up were identified. Patient charts were examined and LDCT scans were analyzed using body segmentation software to identify characteristics potentially associated with frailty and injury. Hospitalization was defined as an admission >48 hours within 1 year of the LDCT scan; admissions for elective procedures were excluded.

There were 1606 LDCT scans that met inclusion criteria. The cohort median age was 65 years (interquartile range, 61-70 years), with 54% (875/1606) female, 50% (804/1606) current smokers, and median smoking history of 40 pack-years (interquartile range, 34-50 pack-years). There were 107 hospitalizations within 1 year of the LDCT scan. On univariate analysis, cardiomegaly (odds ratio [OR], 2.83; 95% CI, 1.33-6.04; P < .01), emphysema (OR, 1.67; 95% CI, 1.09-2.56; P = .02), pulmonary artery enlargement (OR, 2.72; 95% CI, 1.09-6.62; P = .03), and coronary artery calcification (OR, 1.59; 95% CI, 1.07-2.41; P = .02) were associated with increased risk of hospitalization. On multivariate analysis, after controlling for age and sex, cardiomegaly (OR, 2.41; 95% CI, 1.05-4.97; P = .03), emphysema (OR, 1.88; 95% CI, 1.19-2.93; P < .01), and body mass index >30 kg/m² (OR, 1.55; 95% CI, 1.02-2.36; P = .04) were associated with increased risk of hospitalization.

In lung cancer screening patients, features extractable from LDCT scans are associated with increased risk of hospitalizations during the subsequent year.