Artificial intelligence-powered chest computed tomography analysis unveils prognostic insights for COVID-19 mortality among prevalent hemodialysis patients.

IF 2.9 3区医学 Q1 UROLOGY & NEPHROLOGY

Kidney Research and Clinical Practice Pub Date : 2024-09-26 DOI:10.23876/j.krcp.24.079

Eunji Kim, Soo-Jin Yoon, Sungbong Yu, Eunsil Ko, Kyungjun Shon, Jooyeon Yoon, Youn Kyung Kee, Do Hyoung Kim, AJin Cho, Hayne Cho Park, Young-Ki Lee

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引用次数: 0

Abstract

Background: Coronavirus disease 2019 (COVID-19) has led to severe pneumonia and mortality worldwide, however, clinical outcomes in end-stage renal disease patients remain unclear. This study evaluates the prognostic value of chest computed tomography (CT) findings in predicting COVID-19-related outcomes in prevalent hemodialysis patients.

Methods: We retrospectively analyzed 326 prevalent hemodialysis patients diagnosed with COVID-19 who underwent chest CT scans. Characteristics assessed included pleural effusion, lung involvement volume, nodular consolidation, patchy infiltration, and ground-glass opacity. Artificial intelligence (AI)-assisted CT analysis quantified lung involvement. The primary endpoint was in-hospital mortality. Clinical data were collected, and logistic regression analysis assessed the association between CT findings and mortality.

Results: The mean age of the patients was 66.7 ± 12.6 years, 61.0% were male, and 58.6% were diabetic. Chest CT showed that 18.1% had lung involvement >10%, 32.5% had pleural effusion, 68.7% had nodular consolidation, 57.1% had patchy infiltration, and 58.0% had ground-glass opacity. Seventy patients (21.5%) died. Multivariate logistic regression analysis identified lung involvement >2.7% (odds ratio [OR], 16.70; 95% confidence interval [CI], 4.35-65.63), pleural effusion (OR, 3.28; 95% CI, 1.15-9.35), nodular consolidation (OR, 4.08; 95% CI, 1.12-14.82), and patchy infiltration (OR, 3.75; 95% CI, 1.17-12.03) as significant mortality risk factors.

Conclusion: Chest CT findings, including lung involvement >2.7% and the presence of pleural effusion, nodular consolidation, and patchy infiltrates, significantly indicated mortality in COVID-19 pneumonia among prevalent hemodialysis patients. AI-assisted CT analysis proved useful in assessing lung involvement extent, showing that even minimal lung involvement can be associated with increased mortality.

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人工智能驱动的胸部计算机断层扫描分析揭示了流行性血液透析患者 COVID-19 死亡率的预后见解。

背景：冠状病毒病2019（COVID-19）已在全球范围内导致严重肺炎和死亡，然而，终末期肾病患者的临床结局仍不清楚。本研究评估了胸部计算机断层扫描（CT）结果在预测流行性血液透析患者 COVID-19 相关预后中的预后价值：我们回顾性分析了326名被确诊为COVID-19并接受了胸部CT扫描的流行性血液透析患者。评估的特征包括胸腔积液、肺受累体积、结节性合并症、斑片状浸润和磨玻璃不透明。人工智能（AI）辅助 CT 分析量化了肺部受累情况。主要终点是院内死亡率。研究人员收集了临床数据，并通过逻辑回归分析评估了CT结果与死亡率之间的关联：患者的平均年龄为（66.7 ± 12.6）岁，61.0%为男性，58.6%为糖尿病患者。胸部 CT 显示，18.1% 的患者肺部受累程度大于 10%，32.5% 的患者出现胸腔积液，68.7% 的患者出现结节性合并症，57.1% 的患者出现斑片状浸润，58.0% 的患者出现磨玻璃样混浊。70名患者（21.5%）死亡。多变量逻辑回归分析发现，肺部受累>2.7%（几率比[OR]，16.70；95% 置信区间[CI]，4.35-65.63）、胸腔积液（OR，3.28；95% CI，1.15-9.35）、结节性合并症（OR，4.08；95% CI，1.12-14.82）和斑片状浸润（OR，3.75；95% CI，1.17-12.03）是重要的死亡风险因素：结论：胸部CT检查结果，包括肺部受累>2.7%、胸腔积液、结节性合并症和斑片状浸润的存在，可显著提示流行性血液透析患者COVID-19肺炎的死亡率。事实证明，人工智能辅助 CT 分析有助于评估肺部受累程度，表明即使是极小的肺部受累也会增加死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney Research and Clinical Practice UROLOGY & NEPHROLOGY-

CiteScore

4.60

自引率

10.00%

发文量

审稿时长

10 weeks

期刊介绍： Kidney Research and Clinical Practice (formerly The Korean Journal of Nephrology; ISSN 1975-9460, launched in 1982), the official journal of the Korean Society of Nephrology, is an international, peer-reviewed journal published in English. Its ISO abbreviation is Kidney Res Clin Pract. To provide an efficient venue for dissemination of knowledge and discussion of topics related to basic renal science and clinical practice, the journal offers open access (free submission and free access) and considers articles on all aspects of clinical nephrology and hypertension as well as related molecular genetics, anatomy, pathology, physiology, pharmacology, and immunology. In particular, the journal focuses on translational renal research that helps bridging laboratory discovery with the diagnosis and treatment of human kidney disease. Topics covered include basic science with possible clinical applicability and papers on the pathophysiological basis of disease processes of the kidney. Original researches from areas of intervention nephrology or dialysis access are also welcomed. Major article types considered for publication include original research and reviews on current topics of interest. Accepted manuscripts are granted free online open-access immediately after publication, which permits its users to read, download, copy, distribute, print, search, or link to the full texts of its articles to facilitate access to a broad readership. Circulation number of print copies is 1,600.