Low-Dose Computed Tomography Scan Features Are Associated With Annual Risk of Hospitalization.

Background: The objective of this study was to investigate whether lung cancer screening low-dose computed tomography (LDCT) can be used to identify features associated with increased risk of hospitalization during the subsequent year.

Methods: Patients who underwent lung cancer screening between 2015 and 2020 with at least 1-year follow-up were identified. Patient charts were examined and LDCT scans were analyzed using body segmentation software to identify characteristics potentially associated with frailty and injury. Hospitalization was defined as an admission >48 hours within 1 year of the LDCT scan; admissions for elective procedures were excluded.

Results: There were 1606 LDCT scans that met inclusion criteria. The cohort median age was 65 years (interquartile range, 61-70 years), with 54% (875/1606) female, 50% (804/1606) current smokers, and median smoking history of 40 pack-years (interquartile range, 34-50 pack-years). There were 107 hospitalizations within 1 year of the LDCT scan. On univariate analysis, cardiomegaly (odds ratio [OR], 2.83; 95% CI, 1.33-6.04; < .01), emphysema (OR, 1.67; 95% CI, 1.09-2.56;  = .02), pulmonary artery enlargement (OR, 2.72; 95% CI, 1.09-6.62; .03), and coronary artery calcification (OR, 1.59; 95% CI, 1.07-2.41;  = .02) were associated with increased risk of hospitalization. On multivariate analysis, after controlling for age and sex, cardiomegaly (OR, 2.41; 95% CI, 1.05-4.97;  = .03), emphysema (OR, 1.88; 95% CI, 1.19-2.93; < .01), and body mass index >30 kg/m (OR, 1.55; 95% CI, 1.02-2.36;  = .04) were associated with increased risk of hospitalization.

Conclusions: In lung cancer screening patients, features extractable from LDCT scans are associated with increased risk of hospitalizations during the subsequent year.