Journal of Personalized Medicine (Jun 2021)
Machine Learning to Predict In-Hospital Mortality in COVID-19 Patients Using Computed Tomography-Derived Pulmonary and Vascular Features
- Simone Schiaffino,
- Marina Codari,
- Andrea Cozzi,
- Domenico Albano,
- Marco Alì,
- Roberto Arioli,
- Emanuele Avola,
- Claudio Bnà,
- Maurizio Cariati,
- Serena Carriero,
- Massimo Cressoni,
- Pietro S. C. Danna,
- Gianmarco Della Pepa,
- Giovanni Di Leo,
- Francesco Dolci,
- Zeno Falaschi,
- Nicola Flor,
- Riccardo A. Foà,
- Salvatore Gitto,
- Giovanni Leati,
- Veronica Magni,
- Alexis E. Malavazos,
- Giovanni Mauri,
- Carmelo Messina,
- Lorenzo Monfardini,
- Alessio Paschè,
- Filippo Pesapane,
- Luca M. Sconfienza,
- Francesco Secchi,
- Edoardo Segalini,
- Angelo Spinazzola,
- Valeria Tombini,
- Silvia Tresoldi,
- Angelo Vanzulli,
- Ilaria Vicentin,
- Domenico Zagaria,
- Dominik Fleischmann,
- Francesco Sardanelli
Affiliations
- Simone Schiaffino
- Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 Milan, Italy
- Marina Codari
- Department of Radiology, School of Medicine, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA
- Andrea Cozzi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Luigi Mangiagalli 31, 20133 Milan, Italy
- Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
- Marco Alì
- Department of Diagnostic Imaging and Stereotactic Radiosurgery, C.D.I. Centro Diagnostico Italiano S.p.A., Via Simone Saint Bon 20, 20147 Milan, Italy
- Roberto Arioli
- Radiodiagnostics, Department of Diagnosis and Treatment Services, Azienda Ospedaliero Universitaria Maggiore della Carità, Corso Giuseppe Mazzini 18, 28100 Novara, Italy
- Emanuele Avola
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
- Claudio Bnà
- Unit of Interventional Radiology, Unit of Radiology, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati 57, 25124 Brescia, Italy
- Maurizio Cariati
- Diagnostic and Interventional Radiology Service, ASST Santi Paolo e Carlo, Via Antonio di Rudinì 8, 20142 Milan, Italy
- Serena Carriero
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
- Massimo Cressoni
- Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 Milan, Italy
- Pietro S. C. Danna
- Radiodiagnostics, Department of Diagnosis and Treatment Services, Azienda Ospedaliero Universitaria Maggiore della Carità, Corso Giuseppe Mazzini 18, 28100 Novara, Italy
- Gianmarco Della Pepa
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
- Giovanni Di Leo
- Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 Milan, Italy
- Francesco Dolci
- Emergency Department, ASST Crema—Ospedale Maggiore, Largo Ugo Dossena 2, 26013 Crema, Italy
- Zeno Falaschi
- Radiodiagnostics, Department of Diagnosis and Treatment Services, Azienda Ospedaliero Universitaria Maggiore della Carità, Corso Giuseppe Mazzini 18, 28100 Novara, Italy
- Nicola Flor
- Unit of Radiology, Ospedale Universitario Luigi Sacco—ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi 74, 20157 Milan, Italy
- Riccardo A. Foà
- Diagnostic and Interventional Radiology Service, ASST Santi Paolo e Carlo, Via Antonio di Rudinì 8, 20142 Milan, Italy
- Salvatore Gitto
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Luigi Mangiagalli 31, 20133 Milan, Italy
- Giovanni Leati
- Unit of Interventional Radiology, Unit of Radiology, ASST Crema—Ospedale Maggiore, Largo Ugo Dossena 2, 26013 Crema, Italy
- Veronica Magni
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Luigi Mangiagalli 31, 20133 Milan, Italy
- Alexis E. Malavazos
- High Speciality Center for Dietetics, Nutritional Education and Cardiometabolic Prevention, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 Milan, Italy
- Giovanni Mauri
- Department of Oncology and Hematology-Oncology, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
- Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
- Lorenzo Monfardini
- Unit of Interventional Radiology, Unit of Radiology, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati 57, 25124 Brescia, Italy
- Alessio Paschè
- Radiodiagnostics, Department of Diagnosis and Treatment Services, Azienda Ospedaliero Universitaria Maggiore della Carità, Corso Giuseppe Mazzini 18, 28100 Novara, Italy
- Filippo Pesapane
- Division of Breast Radiology, IEO—Istituto Europeo di Oncologia IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy
- Luca M. Sconfienza
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Luigi Mangiagalli 31, 20133 Milan, Italy
- Francesco Secchi
- Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 Milan, Italy
- Edoardo Segalini
- Department of General and Emergency Surgery, ASST Crema—Ospedale Maggiore, Largo Ugo Dossena 2, 26013 Crema, Italy
- Angelo Spinazzola
- Unit of Interventional Radiology, Unit of Radiology, ASST Crema—Ospedale Maggiore, Largo Ugo Dossena 2, 26013 Crema, Italy
- Valeria Tombini
- ASST Grande Ospedale Metropolitano Niguarda, Piazza dell’Ospedale Maggiore 3, 20162 Milan, Italy
- Silvia Tresoldi
- Diagnostic and Interventional Radiology Service, ASST Santi Paolo e Carlo, Via Antonio di Rudinì 8, 20142 Milan, Italy
- Angelo Vanzulli
- Department of Oncology and Hematology-Oncology, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
- Ilaria Vicentin
- ASST Grande Ospedale Metropolitano Niguarda, Piazza dell’Ospedale Maggiore 3, 20162 Milan, Italy
- Domenico Zagaria
- Radiodiagnostics, Department of Diagnosis and Treatment Services, Azienda Ospedaliero Universitaria Maggiore della Carità, Corso Giuseppe Mazzini 18, 28100 Novara, Italy
- Dominik Fleischmann
- Department of Radiology, School of Medicine, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA
- Francesco Sardanelli
- Unit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097 Milan, Italy
- DOI
- https://doi.org/10.3390/jpm11060501
- Journal volume & issue
-
Vol. 11,
no. 6
p. 501
Abstract
Pulmonary parenchymal and vascular damage are frequently reported in COVID-19 patients and can be assessed with unenhanced chest computed tomography (CT), widely used as a triaging exam. Integrating clinical data, chest CT features, and CT-derived vascular metrics, we aimed to build a predictive model of in-hospital mortality using univariate analysis (Mann–Whitney U test) and machine learning models (support vectors machines (SVM) and multilayer perceptrons (MLP)). Patients with RT-PCR-confirmed SARS-CoV-2 infection and unenhanced chest CT performed on emergency department admission were included after retrieving their outcome (discharge or death), with an 85/15% training/test dataset split. Out of 897 patients, the 229 (26%) patients who died during hospitalization had higher median pulmonary artery diameter (29.0 mm) than patients who survived (27.0 mm, p p < 0.001). SVM and MLP best models considered the same ten input features, yielding a 0.747 (precision 0.522, recall 0.800) and 0.844 (precision 0.680, recall 0.567) area under the curve, respectively. In this model integrating clinical and radiological data, pulmonary artery diameter was the third most important predictor after age and parenchymal involvement extent, contributing to reliable in-hospital mortality prediction, highlighting the value of vascular metrics in improving patient stratification.
Keywords