中国实用内科杂志2024，Vol.44Issue(3)：235-242,8.DOI:10.19538/j.nk2024030111
基于随机生存森林的动静脉内瘘晚期失功预后因素研究
Research on the prognostic factors of arteriovenous fistula late failure based on the random survival forest
摘要
Abstract
Objective To explore prognostic factors of arteriovenous fistula(AVF)late failure in patients on maintenance hemodialysis based on random survival forest(RSF).Methods Select 156 patients on maintenance hemodialysis(MHD)who first received AVF in the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from October 2018 to June 2022 as the research subjects.According to whether arteriovenous fistula late failure occurred,patients were divided into patency group(n=1 16)and failure group(n=40);explore the prognostic factors of AVF late failure.Results According to random survival forest results,the prognostic risk factors of arteriovenous fistula late failure were platelet count,triglyceride,fibrin,age,albumin,blood calcium,D-dimer and C reactive protein.The results of the Cox regression model showed that platelet counts(HR 1.02,95％CI 1.012-1.030,P＜0.001)and blood calcium(HR 8.84,95％CI 1.186-65.840,P=0.034)were independent influence factors of arteriovenous fistula late failure.According to the error prediction curve drawn by Brier score,the prediction performance of RSF was generally better than the Cox regression model.The effective prognostic factors determined by RSF-Cox model were platelet count,triglyceride,fibrin,age,albumin and blood calcium.Conclusion The random survival forest model has good selectability in the analysis of prognostic factors of arteriovenous fistula late failure.The random survival forest model established in this study can help clinicians identify patients with high-risk factors and carry out symptomatic intervention,which facilitates nursing and timely intervention to extend the use time of AVF.关键词
随机生存森林/Cox比例风险回归模型/动静脉内瘘/晚期失功/维持性血液透析Key words
random survival forest/Cox regression model/arteriovenous fistula/late failure/maintenance hemodialysis分类
医药卫生引用本文复制引用
翁雪莹,吴慧敏,陈宇珊,左金巾,罗芳,钟建..基于随机生存森林的动静脉内瘘晚期失功预后因素研究[J].中国实用内科杂志,2024,44(3):235-242,8.基金项目
国家自然科学基金委员会地区科学基金项目(81760807) （81760807）
