右江医学2026，Vol.54Issue(1)：19-26,8.DOI:10.3969/j.issn.1003-1383.2026.01.003
基于logistic回归构建脑死亡患者家属器官捐献决策预测模型及其影响因素分析
Construction of predictive model for organ donation decisions of family members of brain death patients based on logistic regression and analysis of its influencing factors
摘要
Abstract
Objective To explore key factors influencing family decision-making regarding organ donation in brain-dead patients,and to construct a predictive model,so as to inform clinical communication and donation process optimization.Methods A total of 150 brain-dead patients admitted to the ICU of Cenxi People's Hospital and their 434 family members from January 2022 to December 2024 were included,and the characteristics of patients,family members,and decision-mak-ing processes were collected.The consent to donate was used as dependent variable,and univariate and multivariate logistic regression analysis were performed to identify independent influencing factors and construct a predictive model,and then odds ratios(ORs)and 95％confidence intervals(CIs)were calculated.Model calibration and discrimination were assessed by Hosmer-Lemeshow test and the area under the receiver operating characteristic(RC)curve(AUC),and internal validation was performed using Bootstrap method.Results Among 150 brain death patients,organ donation consent rate was 14.7％.Univariate logistic regression identified 9 variables associated with donation willingness(P＜0.05).Multivariate analysis demonstrated that willingness to donate before death,absence of spontaneous respiration,male patients,high-quality commu-nication by the medical team,and absence of family religious belief among family members can significantly promote donation willingness(OR=4.78-6.90,all P＜0.05),while more than 2 decision-makers,third-party responsibility for medical in-surance,and individual patient occupation were obstructive factors(OR=0.31-0.39,all P＜0.05).The model showed good predictive performance(AUC=0.889,95％CI:0.834-0.933;Hosmer-Lemeshow P=0.158),and the Bootstrap-corrected A UC was 0.838,which indicated stable predictive ability.Conclusion The logistic regression-based predictive model demonstrates good performance in forecasting family decisions on organ donation,which can provide quantitative sup-port for clinical practice.Donation willingness before death,absence of religious belief,male patients,lack of autonomous breathing display,high-quality communication,and no more than 2 decision-makers are key factors in promoting donations.关键词
器官捐献/脑死亡/家属决策/预测模型/logistic回归Key words
organ donation/brain death/family decision-making/predictive model/logistic regression分类
医药卫生引用本文复制引用
张洪宾,高汉铭,廖吉祥,黄一洪,陈秋明,陆海生,罗庆教,刘远波..基于logistic回归构建脑死亡患者家属器官捐献决策预测模型及其影响因素分析[J].右江医学,2026,54(1):19-26,8.基金项目
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20211305) （Z20211305）
广西医疗卫生重点学科建设项目(桂卫科发[2019]19号) （桂卫科发[2019]19号）
