Prognostic Significance of Computed Tomography Severity Score for Machine Learning Prediction of Intensive Care Unit...

The computed tomography-severity score (CT-SS) quantifies the severity of pulmonary involvement and is significantly associated with disease severity, intensive care unit (ICU) admissions, and mortality in coronavirus disease-2019 (COVID-19) patients. There is very limited information on the prognostic value of CT-SS when used in machine learning (ML) models to predict ICU admission in COVID-19 patients. In this study, the prognostic significance of CT-SS in ML model-based prediction of ICU admission among COVID-19 patients was evaluated.

In this retrospective study, a hospital-based database from 6,854 COVID-19 patients was reviewed. To evaluate the prognostic significance of CT-SS in predicting ICU admission in patients, seven ML methods were trained separately using the most important features, with and without CT-SS data, and their performances were compared.

After applying exclusion criteria, 815 COVID-19 patients remained. Just over half of the patients (54.85%) were male, and the mean age was 57.22±16.76 years. The CT-SS index was the strongest predictor among the parameters examined, and integrating this index into the training dataset enhanced ML model performance. The k-nearest neighbors model with 93.3% accuracy, 97.3% sensitivity, 89.4% specificity, and an area under the curve of approximately 98.8% showed the best performance for predicting ICU admission in COVID-19 patients.

The results showed that CT-SS is a key predictor for ML models of ICU admission in COVID-19 patients. The ML models developed using a dataset including CT-SS are efficient risk stratification tools for identifying critical COVID-19 patients, thereby facilitating optimal allocation of limited hospital resources.