Pulmonary contusion volume and radiomics as predictors of early-onset pneumonia in trauma patients, a retrospective single-centre study.

Purpose: Pulmonary contusion is a common injury in thoracic trauma patients and a significant risk factor for respiratory complications such as pneumonia. This study aimed to investigate the role of pulmonary contusion volume and radiomics as predictors of pneumonia within 7 days of trauma and the d...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 51; no. 1; pp. 1 - 12
Autores principales: Gamberini, Lorenzo, Astuti, Giovanna Maria, Biavati, Bianca, Boarato, Davide, Tontodonati, Matteo, Palmitessa, Irene, Laruccia, Matteo, Coniglio, Carlo, Bertini, Alessio, Orlandi, Paolo Emilio, Tartaglione, Marco, Allegri, Davide, Bruno, Antonio
Formato: research tables/charts Journal Article
Publicado: Springer Nature 8/22/2025
Acceso en línea:Ver este registro en EBSCOhost
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        10.1007/s00068-025-02952-1
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        atl: Pulmonary contusion volume and radiomics as predictors of early-onset pneumonia in trauma patients, a retrospective single-centre study.
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        au:
          Gamberini, Lorenzo
          Astuti, Giovanna Maria
          Biavati, Bianca
          Boarato, Davide
          Tontodonati, Matteo
          Palmitessa, Irene
          Laruccia, Matteo
          Coniglio, Carlo
          Bertini, Alessio
          Orlandi, Paolo Emilio
          Tartaglione, Marco
          Allegri, Davide
          Bruno, Antonio
        affil: https://ror.org/010tmdc88 Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy
      sug:
        subj:
          Lung Anatomy and Histology
          Contusions and Abrasions
          Lung Injury
          Radiomics
          Pneumonia Risk Factors
          Trauma Complications
          Human
          Retrospective Design
          Nonexperimental Studies
          Emergency Patients
          Patient Admission
          Tomography, X-Ray Computed
          Emergency Service
          Medical Records
          ROC Curve
          Poisson Distribution
          Regression
          Multivariate Analysis
          Validity
          Thoracic Injuries Complications
          Questionnaires
      ab: Purpose: Pulmonary contusion is a common injury in thoracic trauma patients and a significant risk factor for respiratory complications such as pneumonia. This study aimed to investigate the role of pulmonary contusion volume and radiomics as predictors of pneumonia within 7 days of trauma and the degree of overlap between contused lung segments and those where pneumonia subsequently developed. Methods: This retrospective observational study included all consecutive adult trauma patients admitted to the ED with a whole-body CT scan available within 6 h from admission. The primary outcome was the occurrence of early-onset pneumonia (EOP). Data were extracted from clinical records and CT scan images were analysed for volumetric and radiomic analysis. ROC curves were built, and robust Poisson regression and extreme gradient boosting models were developed to evaluate the most influential clinical and radiologic variables. Results: Among 486 patients included, 79 (16.3%) developed early-onset pneumonia. Volumetric analysis showed higher contused lung volumes and proportions in pneumonia patients. The contusion percentage had the highest AUC (0.644) for predicting pneumonia over T-AIS and AAST lung injury scales. Multivariable analysis identified H-AIS, contusion proportion, and P/F ratio as significant predictors, with a model AUC of 0.710. Radiomic analysis improved prediction accuracy, with an extreme gradient boosting model showing an estimated out-of-sample AUC of 0.790. Conclusion: Pulmonary contusion volume is an interesting predictor of early-onset pneumonia in thoracic trauma patients. Advanced radiology techniques, including radiomics, could enhance prediction accuracy and aid in early risk stratification, potentially improving patient outcomes. Trial registration: NCT06750822, retrospectively registered.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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