arXiv:2605.18878eess.SPcs.CV2026-05

用肺部超声影像预测心衰患者30天再入院风险,效果优于传统方法。

Prognostic Value of Lung Ultrasound Biomarkers for Readmission Risk in Congestive Heart Failure: A Pilot Data-Driven Analysis

论文配图:Prognostic Value of Lung Ultrasound Biomarkers for Readmission Risk in Congestive Heart Failure: A Pilot Data-Driven Analysis
图 1 · 摘自论文原文
  • 通过机器学习分析住院期间的肺超声图像,提取时空特征
  • 多视角融合与时间差特征使模型F1达0.80,表现最佳
  • 胸膜线异常与经典B线同样具有重要预后价值

心力衰竭(CHF)患者出院后30天内再入院是导致发病率、死亡率和医疗支出增加的主要因素。现有风险分层工具主要依赖非影像数据,预测性能有限。床旁肺超声(LUS)可无创敏感检测肺部淤血,但其在再入院预测中的预后价值尚未充分探索。本研究首次系统性地利用住院期间采集的B模式肺超声,通过机器学习预测30天再入院风险。采用预训练的时间移位模块(TSM)ResNet-18编码器提取定量时空嵌入,并独立评估可解释的生物标志物特征。通过结构化消融实验,分析了不同肺区视图、时间表示、多视角融合及跨肺增强的影响,发现:(1) 依赖性下肺区域(左3区、右3区)具有最强预后信号,符合其易受静水压淤血影响的特点;(2) 时序差异特征显著优于单一时点表示,凸显追踪疾病进展的重要性;(3) 多视角特征拼接表现最优,顶级MLP模型的F1得分为0.80(95%置信区间:0.62–0.96)。生物标志物分析进一步表明,胸膜线异常(包括断裂和凹陷)的诊断信息量与经典的A线、B线相当。结果支持基于POCUS的生物标志物作为实用、可解释的非侵入性心衰风险分层工具。

原文摘要 · Abstract (English)

Hospital readmission within 30 days of discharge is a leading driver of morbidity, mortality, and avoidable healthcare expenditure in congestive heart failure (CHF). Current clinical risk stratification tools rely primarily on non-imaging data and exhibit limited predictive performance. Point-of-care lung ultrasound (LUS) offers a sensitive, noninvasive window into the pulmonary congestion that characterizes CHF decompensation, yet its prognostic utility for readmission prediction remains largely unexplored. We present a pilot feasibility study, the first systematic machine learning study using B-mode LUS acquired during hospitalization to predict 30-day CHF readmission. Quantitative spatiotemporal embeddings are extracted from a pretrained Temporal Shift Module (TSM) ResNet-18 encoder, and interpretable biomarker features are separately evaluated. Through structured ablations over lung view, temporal representation, multi-view fusion, and cross-lung augmentation, we identify the key imaging factors driving readmission risk. Our findings reveal that (1) dependent lower-lung regions (Left-3, Right-3) carry the strongest prognostic signal, consistent with their greater susceptibility to hydrostatic congestion; (2) temporal difference features between sequential examinations substantially outperform single-timepoint representations, highlighting the importance of capturing disease trajectory; and (3) multi-view feature concatenation yields the best overall performance, with our top MLP model achieving an F1 score of 0.80 (95% CI: 0.62-0.96). Biomarker analysis further reveals that pleural-line abnormalities, including breaks and indentations, are as informative as the canonical A-line and B-line markers. These results support POCUS-derived biomarkers as practical, interpretable tools for noninvasive CHF risk stratification.

心衰超声风险预测AI医疗

Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品;中文卡片由大模型生成,请以原文为准。