Accurate outcome prediction after aneurysmal subarachnoid hemorrhage (aSAH) remains challenging due to the heterogeneity of clinical and imaging data. This study compares four machine learning approaches for three-month survival prediction using volumetric CT data and clinical metadata from 733 patients across nine Spanish centers. Using the AUCMEDI framework, we implemented: (1) an image-only 3D DenseNet121 CNN, (2) a CNN with metadata integration via feature-level late fusion, (3) a metadataonly XGBoost model, and (4) a fusion XGBoost model combining CNN predictions with metadata. The image-only CNN achieved the best performance (F1-score = 0.78, AUC = 0.84), confirming the strong prognostic value of CT imaging. Adding metadata slightly reduced performance, while the fusion XGBoost reached a competitive F1-score (0.76) and improved interpretability. These results demonstrate that CT-based deep learning enables reliable survival prediction in aSAH, and that model-level fusion provides aninterpretable alternative.

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Comparative Analysis of Machine Learning Models for 3-month Survival Prediction in Aneurysmal Subarachnoid Hemorrhage

  • Alexia Rizoudis,
  • Santiago Cepeda,
  • Frank Kramer,
  • Dominik Müller

摘要

Accurate outcome prediction after aneurysmal subarachnoid hemorrhage (aSAH) remains challenging due to the heterogeneity of clinical and imaging data. This study compares four machine learning approaches for three-month survival prediction using volumetric CT data and clinical metadata from 733 patients across nine Spanish centers. Using the AUCMEDI framework, we implemented: (1) an image-only 3D DenseNet121 CNN, (2) a CNN with metadata integration via feature-level late fusion, (3) a metadataonly XGBoost model, and (4) a fusion XGBoost model combining CNN predictions with metadata. The image-only CNN achieved the best performance (F1-score = 0.78, AUC = 0.84), confirming the strong prognostic value of CT imaging. Adding metadata slightly reduced performance, while the fusion XGBoost reached a competitive F1-score (0.76) and improved interpretability. These results demonstrate that CT-based deep learning enables reliable survival prediction in aSAH, and that model-level fusion provides aninterpretable alternative.