Radiomics score predicts acute respiratory distress syndrome based on the initial CT scan after trauma.

• Early prediction of acute respiratory distress syndrome in polytraumatized patients is possible, even when using heterogenous data. • Radiomics-based prediction resulted in an area under the curve of 0.79 compared to 0.66 for the injury severity score, and 0.68 for the abbreviated injury score of the thorax. • Highlighting the most relevant lung regions for prediction facilitates the understanding of machine learning-based prediction.