摘要
Abstract
Objective To construct decision tree and random forest models for predicting the postoperative blood pressure recovery in patients with aldosterone-producing adenoma,evaluate their predictive performance,and identify key factors affecting postoperative blood pressure recovery.Methods Clinical data of 211 aldosterone-producing adenoma patients were collected,and the patients were divided into training set and testing set at a ratio of 7∶3.Decision tree and random forest models were built using the training set to predict the postoperative blood pressure recovery in aldosterone-producing adenoma patients,and the models were validated using the testing set.The performance of both models was compared to assess their effectiveness in predicting postoperative blood pressure re-covery.Results Among the 211 aldosterone-producing adenoma patients,79 patients achieved normal blood pressure postopera-tively,while 132 patients showed improvement but did not fully recover.The cure rate of postoperative blood pressure was 37.4%.There were significant differences between the two groups in terms of age,body mass index,duration of hypertension,and estimated glomerular filtration rate(P<0.05).The decision tree model achieved an accuracy of 0.75,a specificity of 0.82,a sensitivity of 0.64,AUC of 0.79,and an F1 score of 0.67.The random forest model achieved an accuracy of 0.81,a specificity of 0.87,a sensitivity of 0.72,AUC of 0.87,and an F1 score of 0.75.Therefore,the random forest model was better than the decision tree model in predictive performance.Conclusion The random forest model can more accurately predict the postoperative blood pressure recovery in aldoste-rone-producing adenoma patients and effectively identify key influencing factors such as age,BMI,duration of hypertension,and eGFR.This model can provide the scientific evidence for clinical treatment and personalized management of postoperative blood pres-sure in aldosterone-producing adenoma patients.关键词
醛固酮瘤/肾上腺切除术/血压/预测模型/决策树模型/随机森林算法模型/影响因素Key words
aldosterone-producing adenoma/adrenalectomy/blood pressure/predictive model/decision tree model/ran-dom forest model/influencing factors分类
临床医学
