We Need to Talk About Lung Ultrasound Score: Prediction of Intensive Care Unit Admission with Machine Learning

The admission of COVID-19 patients to the Intensive Care Unit (ICU) is largely dependent on illness severity, yet no standard criteria exist for this decision. Here, lung ultrasound (LU) data, blood gas analysis (BGA), and clinical parameters from venous blood tests (VBTs) were used, along with machine-learning (ML) models to predict the need for ICU admission. Data from fifty-one COVID-19 patients, including ICU admission status, were collected. The information from LU was gathered through the identification of LU findings (LUFs): B-lines, irregular pleura, subpleural, and lobar consolidations. LU scores (LUSs) were computed by summing predefined weights assigned to each LUF, as reported in previous studies. In addition, individual LUFs were analyzed without calculating a total LUS. Support vector machine models were built, combining the available clinical data to predict ICU admissions. The application of ML models to individual LUFs outperformed standard LUS approaches reported in previous studies. Moreover, combining LU data with results from other medical exams improved the area under the receiver operating characteristic curve (AUC). The model with the best overall performance used variables from all three exams (BGA, LU, VBT), achieving an AUC of 95.5%. Overall, the results demonstrate the significant role of ML models in improving the prediction of ICU admission. Additionally, applying ML specifically to LUFs provided better results compared to traditional approaches that rely on traditional LUSs. The results of this paper are deployed on a web app.