Respiratory failure & ventilation
Association of Acute Respiratory Distress Syndrome Radiographic Findings Identified by Machine Learning and Outcomes of Patients Receiving Invasive Mechanical Ventilation
Authors' conclusion
A deep learning-derived ARDS-CXR score quantifying radiographic findings of ARDS independently predicted mortality and ventilator outcomes beyond hypoxemia and illness severity. Algorithmically derived markers of lung injury severity from chest imaging could be used to support clinical care decisions, predictive enrichment in research studies, or incorporated into a future ARDS definition.
Study context
- Population
- Adult patients with CXRs performed at the time of invasive mechanical ventilation initiationpatients receiving invasive mechanical ventilation
- Participants
- 6,591 patients
- Exposure
- Positive score vs Negative score
- Positive scoren = 1,089
- Outcome
- ARDS-CXR score distribution
Methodological detailsSingle academic medical center
- Single academic medical center
Main finding
As reported in the abstract
Median ARDS-CXR score (acute respiratory distress syndrome (ARDS) probability of 15%)
−2.09
Patients with a positive score (ARDS probability above 50%)
1089
17%
Observational data: associations, not effects.
Further findings
Twenty-eight-day mortality · 28 days
Mortality by ARDS-CXR score below the ARDS threshold
- Mortality at a score of −2
- 12.8%
- Mortality at a score of −1
- 19.9%
- Mortality at a score of 0
- 27.5%
Discrimination of 28-day mortality (area under the receiver operating characteristic (AUROC))
- ARDS-CXR score AUROC
- 0.68 (95% CI, 0.66-0.70)
- Pao2/Fio2 AUROC
- 0.64 (95% CI, 0.62-0.66)
28-day mortality or time to extubation per 1-point increase in ARDS-CXR score, adjusted for Pao2/Fio2 or Acute Physiology and Chronic Health Evaluation-IV
- Significantly associated with higher 28-day mortality or prolonged time to extubation
- Adjusted for either Pao2/Fio2 or Acute Physiology and Chronic Health Evaluation-IV
Original publication
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