中国输血杂志2025，Vol.38Issue(10)：1334-1339,1354,7.DOI:10.13303/j.cjbt.issn.1004-549x.2025.10.006
基于决策树算法的肝脏切除术患者围术期输血影响因素分析
Perioperative blood transfusion in hepatectomy:a decision tree analysis of influencing factors
摘要
Abstract
Objective To investigate the significant factors influencing the need for perioperative blood transfusion in patients undergoing hepatectomy.Methods Medical records of patients who underwent elective hepatectomy in our hospital from January 2020 to December 2021 were retrospectively collected.Variables associated with transfusion were analyzed u-sing traditional logistic regression(LR)and machine learning algorithm,the Classification and Regression Tree(CRT).The predictive values of the two methods were compared by the area under the curve(AUC)of the ROC curve.Results Among the 402 patients,82(20.4%)received blood transfusions.Multivariable logistic regression analysis identified sever-al risk factors for perioperative blood transfusion,including vascular invasion,preoperative hemoglobin level,intraoperative blood loss,duration of surgery,postoperative hemoglobin level,and postoperative complications(P<0.05).In the CRT model for predicting blood transfusion,intraoperative blood loss(cutoff:450 mL)was the parent node,with preoperative Hb,postoperative complications,and hospital stay as child nodes.The LR model demonstrated superior predictive perform-ance compared to the CRT model,with an AUC of 0.971(95%CI:0.956-0.985)vs 0.937(95%CI:0.909-0.965).The difference in AUC between the two methods was statistically significant(P<0.05).Conclusion Although the CRT model did not outperform logistic regression in overall predictive accuracy,it still provides a valuable tool for assisting clini-cians in making decisions about blood transfusion in the perioperative period of hepatectomy,thereby facilitating more indi-vidualized guidance for preoperative blood preparation in clinical practice.关键词
肝脏切除术/围术期输血/逻辑回归/决策树算法Key words
hepatectomy/perioperative blood transfusion/logistic regression/decision tree algorithm分类
临床医学引用本文复制引用
罗成岑,洪琳欧,何春宇,彭安立,杨军..基于决策树算法的肝脏切除术患者围术期输血影响因素分析[J].中国输血杂志,2025,38(10):1334-1339,1354,7.基金项目
四川省科技计划(2023NSFSC1490) （2023NSFSC1490）
