Cluster analysis of thoracic muscle mass using artificial intelligence in severe pneumonia

• Published in: Scientific reports Vol. 14; no. 1; pp. 16912 - 11
• Main Authors: Choi, Yoon-Hee, Kim, Dong Hyun, Jeon, Eun-Tae, Lee, Hyo Jin, Park, Tae Yun, Yoon, Soon Ho, Jin, Kwang Nam, Lee, Hyun Woo
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 23.07.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/53/2422; 692/699/1785; 692/700/1421/1846/2771; Aged; Airway extubation; Artificial Intelligence; Chest; Clinical outcomes; Cluster Analysis; Community-Acquired Infections - diagnostic imaging; Community-Acquired Infections - mortality; Electronic medical records; Extubation; Female; Hospital Mortality; Humanities and Social Sciences; Humans; Intensive care unit; Intensive Care Units; Machine learning; Male; Medical imaging; Middle Aged; Morbidity; Mortality; multidisciplinary; Muscle; Patients; Pneumonia; Pneumonia - diagnostic imaging; Pneumonia - mortality; Prognosis; Science; Science (multidisciplinary); Skeletal; Success; Thorax; Tomography, X-Ray Computed; Pneumonia; Mortality; Machine learning; Muscle; Intensive care unit; Skeletal; Airway extubation
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-67625-2

Severe pneumonia results in high morbidity and mortality despite advanced treatments. This study investigates thoracic muscle mass from chest CT scans as a biomarker for predicting clinical outcomes in ICU patients with severe pneumonia. Analyzing electronic medical records and chest CT scans of 778 ICU patients with severe community-acquired pneumonia from January 2016 to December 2021, AI-enhanced 3D segmentation was used to assess thoracic muscle mass. Patients were categorized into clusters based on muscle mass profiles derived from CT scans, and their effects on clinical outcomes such as extubation success and in-hospital mortality were assessed. The study identified three clusters, showing that higher muscle mass (Cluster 1) correlated with lower in-hospital mortality (8% vs. 29% in Cluster 3) and improved clinical outcomes like extubation success. The model integrating muscle mass metrics outperformed conventional scores, with an AUC of 0.844 for predicting extubation success and 0.696 for predicting mortality. These findings highlight the strong predictive capacity of muscle mass evaluation over indices such as APACHE II and SOFA. Using AI to analyze thoracic muscle mass via chest CT provides a promising prognostic approach in severe pneumonia, advocating for its integration into clinical practice for better outcome predictions and personalized patient management.