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Additive value of computed tomography severity scores to predict lengths of stay in hospital and ICU for COVID-19 patients: a machine learning study

Additive value of CT-SS to predict COVID-19 hospital and ICU LOSs: a ML study

Abstract

Introduction: During the outbreak of COVID-19, most hospitals faced resource shortages due to the great surges in the influx of infected COVID-19 patients and demand exceeding capacities. Predicting the lengths of stay (LOS) of the patients can help to make proper resource-planning decisions. CT-SS accurately determines the disease severity and could be considered an appropriate prognostic factor to predict patients’ LOS.
Objective: In this study, we evaluate the additive value of CT-SS in the prediction of hospital and ICU LOSs of COVID-19 patients.
Methods: This single-center study retrospectively reviewed a hospital-based COVID-19 registry database from 6854 cases of suspected COVID-19. Four well-known ML classification models including kNN, MLP, SVM, and C4.5 decision tree algorithms were used to predict hospital and ICU LOSs of COVID-19 patients. The confusion matrix-based performance measures were used to evaluate the classification performances of the ML algorithms.
Results: For predicting hospital LOS, the MLP model with an accuracy of 96.7%, sensitivity of 100.0%, precision of 93.8%, specificity of 93.4%, and AUC of around 99.4% had the best performance among the other three ML techniques. This algorithm with 95.3% sensitivity, 86.2% specificity, 90.8% accuracy, 87.3% precision, 91.2% F-Measure, and an AUC of 95.8% had also the best performance for predicting ICU LOS of the patients.
Conclusion: The performances of the ML predictive models for predicting hospital and ICU LOSs of COVID-19 patients were improved when CT-SS data was integrated into the input dataset.

1. Pei J, Lin X, Chen Q, editors. Prediction of patients’ length of stay at hospital during COVID-19 pandemic. J Phys Conf Ser. 2021;1802(3): 1-11.
2. Etu E-E, Monplaisir L, Arslanturk
S, Masoud S, Aguwa C, Markevych I, et al. Prediction of length of stay in the emergency department for COVID-19 patients: A machine learning approach. IEEE Access. 2022;10:42243-51.
3. Liu Y, Wang Z, Ren J, Tian Y, Zhou M, Zhou T, et al. A COVID-19 risk assessment decision support system for general practitioners: design and development study. J Med Internet Res. 2020;22(6):1-24.
4. Alom MZ, Rahman M, Nasrin MS, Taha TM, Asari VK. COVID_MTNet: COVID-19 detection with multi-task deep learning approaches. arXiv preprint arXiv:200403747. 2020:1-12.
5. Lai C-C, Shih T-P, Ko W-C, Tang H-J, Hsueh P-R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3):1-9.
6. Bansal A, Padappayil RP, Garg C, Singal A, Gupta M, Klein A. Utility of artificial intelligence amidst the COVID 19 pandemic: a review. J Med Syst. 2020;44:1-6.
7. Hussain A, Bhowmink B, Moreira N. COVID-19 and diabetes: Knowledge in progress. Diabetes Res Clin ract. 2020: 1-10.
8. Moujaess E, Kourie HR, Ghosn M. Cancer patients and research during COVID-19 pandemic: A systematic review of current evidence. Crit Rev Oncol Hematol. 2020;150:1-10.
9. Saadatmand S, Salimifard K, Mohammadi R, Kuiper A, Marzban M, Farhadi A. Using machine learning in prediction of ICU admission, mortality, and length of stay in the early stage of admission of COVID-19 patients. Ann Oper Res. 2022:1-29.
10. Afrash M, Kazemi-Arpanahi H, Ranjbar P, Nopour R, Amraei M, Saki M, et al. Predictive modeling of hospital length of stay in COVID-19 patients using machine learning algorithms. J Med Chem Sci. 2021;4(5):525-37.
11. Orooji A, Shanbehzadeh M, Mirbagheri E, Kazemi-Arpanahi H. Comparing artificial neural network training algorithms to predict length of stay in hospitalized patients with COVID-19. BMC Infect Dis. 2022;22(1):1-13.
12. Mahboub B, Bataineh MTA, Alshraideh H, Hamoudi R, Salameh L, Shamayleh A. Prediction of COVID-19 hospital length of stay and risk of death using artificial intelligence- based modeling. Front Med. 2021;8:1-9.
13. Prync Flato UA, Gomes Rabelo A, Madid Truyts CA, Pereira Cabral KC, Scaldaferri Lages D, Tavares LD, et al. Machine learning model for prediction of intensive care unit length of stay in COVID-19 patients at a Brazilian hospital. Einstein. 2022;20:10-1.
14. Olivato M, Rossetti N, Gerevini AE, Chiari M, Putelli L, Serina I. Machine Learning Models for Predicting Short-Long Length of Stay of COVID-19 Patients. Procedia Comput Sci. 2022;207:1232-41.
15. Alam F, Ananbeh O, Malik KM, Odayani AA, Hussain IB, Kaabia N, et al. Towards Predicting Length of Stay and Identification of Cohort Risk Factors Using Self-Attention-Based Transformers and Association Mining: COVID-19 as a Phenotype. Diagnostics. 2023;13(10):1-16.
16. Zeng X. Length of Stay Prediction Model of Indoor Patients Based on Light Gradient Boosting Machine. Comput Intell Neurosci. 2022;2022:1-14.
17. Özbilen M, Cebeci Z, Korkmaz A, Yasemin K, Erbakan K. Prediction of Short or Long Length of Stay COVID-19 by Machine Learning. Med Records. 2023;5(3):500-6.
18. Dan T, Li Y, Zhu Z, Chen X, Quan W, Hu Y, et al., editors. Machine learning to predict ICU admission, ICU mortality and survivors’ length of stay among COVID-19 patients: toward optimal allocation of ICU resources. 2020 IEEE international conference on bioinformatics and biomedicine (BIBM); 2020: 555-561.
19. Samy SS, Karthick S, Ghosal M, Singh S, Sudarsan J, Nithiyanantham S. Adoption of machine learning algorithm for predicting the length of stay of patients (construction workers) during COVID pandemic. Int J Inf Technol. 2023;15(5):1-9.
20. Ebinger J, Wells M, Ouyang D, Davis T, Kaufman N, Cheng S, et al. A machine learning algorithm predicts duration of hospitalization in COVID-19 patients. Intell -Based Med. 2021;5:1-5.
21. Alabbad DA, Almuhaideb AM, Alsunaidi SJ, Alqudaihi KS, Alamoudi FA, Alhobaishi MK, et al. Machine learning model for predicting the length of stay in the intensive care unit for COVID-19 patients in the eastern province of Saudi Arabia. Inform Med Unlocked. 2022;30:1-10.
22. Zakariaee SS, Naderi N, Rezaee D. Prognostic accuracy of visual lung damage computed tomography score for mortality prediction in patients with COVID-19 pneumonia: a systematic review and meta-analysis. Egypt J Radiol Nucl Med. 2022;53(1):1-9.
23. Zakariaee SS, Salmanipour H, Naderi N, Kazemi-Arpanahi H, Shanbehzadeh M. Association of chest CT severity score with mortality of COVID-19 patients: a systematic review and meta-analysis. Clin Transl Imaging. 2022;10(6):663-76.
24. Alimohamadi Y, Yekta EM, Sepandi M, Sharafoddin M, Arshadi M, Hesari E. Hospital length of stay for COVID-19 patients: a systematic review and meta-analysis. Multidiscip Respir Med. 2022;17(1):1-12.
25. Li K, Fang Y, Li W, Pan C, Qin P, Zhong Y, et al. CT image visual quantitative evaluation and clinical classification of coronavirus disease (COVID-19). Eur Radiol. 2020; 30:4407-16.
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IssueVol 10 No 4 (2024) QRcode
SectionArticles
DOI https://doi.org/10.18502/jbe.v10i4.18528
Keywords
Chest CT severity score COVID-19 CT-SS Machine learning Length of stay

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How to Cite
1.
Zakariaee SS, Molazadeh M, Salmanipour H, Naderi N. Additive value of computed tomography severity scores to predict lengths of stay in hospital and ICU for COVID-19 patients: a machine learning study. JBE. 2025;10(4):469-483.