摘要
Abstract
Objective To investigate the impact of surgical procedures,biochemical indicators,and patients'baseline characteris-tics on hypocalcemia after thyroid surgery for laying the groundwork for making personalized treatment plans,and establish a random forest-based model for predicting the risk of post-thyroidectomy hypocalcemia for preoperative risk assessment of patients.Methods Clinical data of 600 patients who underwent thyroid surgery in the Department of Thyroid Surgery in the First Hospital of Shanxi Medi-cal University from January 2023 to January 2024 were retrospectively collected.Inter-group comparisons were performed using the Chi-square test.Univariate and multivariate Logistic regression analyses were first employed to identify the influencing factors of post-thyroidectomy hypocalcemia,and then R software was used to establish variable importance rankings and construct the random forest prediction model.Results The incidence of short-term hypocalcemia after thyroid surgery among the 600 patients was 34.17%.Mul-tivariate Logistic regression analysis revealed that age>50 years,female,malignant pathology,hyperthyroidism,reoperation,operation time≥100 min,and a postoperative parathyroid hormone decrease>70%were risk factors for short-term hypocalcemia(P<0.05).Partial thyroidectomy,BMI≥24 kg/m²,preoperative serum calcium,and inorganic phosphorus were identified as protective factors(P<0.05).The area under the ROC curve for the random forest model predicting the risk of short-term hypocalcemia was 0.869 9,with a sensitivity of 82.11%and a specificity of 80.51%.Conclusion The established random forest model can effectively assess the risk of short-term hypocalcemia after thyroid surgery.Factors such as age>50 years,female,and malignant pathology are risk factors for short-term hypocalcemia,while partial thyroidectomy and BMI≥24 kg/m² are protective factors.关键词
甲状腺手术/短期低钙血症/随机森林/预测模型/影响因素/危险因素Key words
thyroid surgery/short-term hypocalcemia/random forest/predictive model/influencing factors/risk factors分类
临床医学
