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老年病人缺血性脑卒中后衰弱预测模型的前瞻性研究

张玲慧 王亚喜 陈晨 杜钦霞 庞旭峰

全科护理2024,Vol.22Issue(8):1398-1404,7.
全科护理2024,Vol.22Issue(8):1398-1404,7.DOI:10.12104/j.issn.1674-4748.2024.08.003

老年病人缺血性脑卒中后衰弱预测模型的前瞻性研究

A prospective study of prediction model for frailty after ischemic stroke in elderly patients

张玲慧 1王亚喜 1陈晨 1杜钦霞 2庞旭峰2

作者信息

  • 1. 266021,青岛大学护理学院
  • 2. 266000,青岛大学附属医院
  • 折叠

摘要

Abstract

Objective:To investigate the influencing factors of frailty after ischemic stroke in elderly patients and construct frailty risk decision tree prediction model.Methods:A total of 485 elderly patients with ischemic stroke admitted to the department of neurology in a third grade A hospital in Qingdao from July 2022 to April 2023.Among them,441 patients completed follow-up and were divided into a frailty group(134 cases)and a non-frailty group(307 cases)according to whether frailty occurred within 3 months after discharge.Univariate analysis and Logistic regression were used to analyze the influencing factors of frailty in elderly patients with ischemic stroke.Python software was used to construct a decision tree model for predicting frailty in elderly patients with ischemic stroke.Results:Stroke frequency(OR=5.899),National Institutes of Health Stroke Scale(NIHSS)score(OR=2.150),geriatric depression(OR=1.673),grip strength(OR=0.921),Barthel index(OR=0.954),general self-efficacy(OR=0.779),social support(OR=0.860)were the important factors affecting the debilitation of elderly patients with ischemic stroke.The results of CART decision tree model showed that NIHSS score,geriatric depression,grip strength,general self-efficacy and social support were predictive factors of occurrence of frailty in elderly patients with ischemic stroke.The top three variables with high contribution to the model were NIHSS score(45.342%),geriatric depression(26.124%)and grip strength(15.297%).The performance of the decision tree model is excellent,and the area under the ROC curve on the training set and the test set reach 0.94 and 0.92 respectively.Conclusions:CART decision tree model can easily and accurately screen out high-risk patients with frailty,which can provide basis for formulating targeted intervention measures to avoid frailty in elderly patients with ischemic stroke.

关键词

缺血性脑卒中/衰弱/预测模型/决策树

Key words

ischemic stroke/frailty/prediction model/decision tree

引用本文复制引用

张玲慧,王亚喜,陈晨,杜钦霞,庞旭峰..老年病人缺血性脑卒中后衰弱预测模型的前瞻性研究[J].全科护理,2024,22(8):1398-1404,7.

全科护理

1674-4748

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