摘要
Abstract
Objective:To analyze the early warning factors and nursing strategies for deep vein thrombosis(DVT)in lower extremities of hospitalized patients in spinal surgery based on random forest-Logistic regression.Methods:A total of 42 patients with DVT(DVT group)and 127 patients without DVT(non-DVT group)hospitalized in the spinal surgery department of our hospital from August 2021 to August 2023 were selected.Clinical data of the two groups were compared.Random forest algorithm was used to screen and reduce the statistically significant DVT characteristic variables between the two groups.Logistic regression analysis was then performed on the early warning factors for DVT in hospitalized patients in spinal surgery.Results:The DVT group had higher rates of age,body mass index,operation time,intraoperative blood loss,diabetes,hyperlipidemia,smoking history,multiple fractures,spinal cord injury,prone position surgery,and intraoperative blood transfusion compared to the non-incidence group.DVT also had longer bed rest period,a lower rate of patients receiving intermittent pneumatic compression devices(IPC)and ankle pump exercises,and lower RHDS scores compared to the non-incidence group(P＜0.05).The random forest algorithm ranked the 15 variables by importance based on the average Gini index.The out-of-bag error rate was lowest when the number of variables was 10.Therefore,the top 10 variables in importance were included as predictors of DVT in hospitalized spinal surgery patients in the multivariate Logistic regression analysis.TIC regression analysis and stepwise regression analysis showed that diabetes mellitus(OR=3.207),hyperlipidemia(OR=3.846),multiple fractures(OR=4.652),concomitant spinal cord injury(OR=7.164),surgical position(OR=4.741),intraoperative blood transfusion(OR=5.168),and bed rest time(OR=3.835)were risk factors for deep vein thrombosis(DVT)in hospitalized spinal surgery patients.IPC(OR=0.481),ankle pump exercises(OR=0.314),and RHDS score(OR=0.371)were protective factors against DVT in hospitalized spinal surgery patients(P＜0.05).Conclusion:Concomitant spinal cord injury,intraoperative blood transfusion,bed rest time,multiple fractures,ankle pump exercises,IPC,diabetes mellitus,discharge readiness,hyperlipidemia,and surgical position were the top 10 risk factors for DVT in hospitalized spinal surgery patients.Developing nursing strategies targeting these factors can help prevent DVT and promote better patient outcomes.关键词
随机森林/Logistic回归/脊柱外科/下肢深静脉血栓/预警因素/护理对策Key words
random forest/Logistic regression/spinal surgery/deep vein thrombosis of the lower extremities/early warning factors/nursing strategies
