Prediction of Postoperative Pancreatitis in Patients with Tumor and Bile Duct Occupation Based on Logistic Regression and Decision Tree Method
Objective To study the influencing factors of complicated pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP)based on logistic regression and decision tree method.Methods A total of 149 patients with lower segment cholangiocarcinoma complicated with bile duct space admitted to Henan Cancer Hospital from March 2020 to March 2023 were selected to receive ERCP.After admission,the clinical data of the patients were collected.According to whether the patients had postoperative pancreatitis,they were divided into the occurrence group and the non-occurrence group,and the clinical data of the two groups were compared.Logistic regression and decision tree were used to analyze the influencing factors of postoperative pancreatitis in patients with ERCP,and receiver operating characteristic(ROC)curve was used to analyze the results of logistic regression analysis and decision tree model analysis.Results A total of 29(19.46％)of the 149 patients with postoperative pancreatitis were divided into the occurrence group(n=29)and non-occurrence group(n=120).Gender,age,body mass index(BMI),hypertension,diabetes,smoking,alcohol consumption,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),fasting blood glucose(FPG),amylase(AMY)and other general data of the two groups were compared.There were no statistical difference(P＞0.05).The acute physiology and chronic health evalution Ⅱ(APACHE Ⅱ)score,history of pancreatitis,pancreatic imaging and intubation difficulties of patients in the occurrence group were statistically significant compared with those in the non-occurrence group(P＜0.05).Logistic regression analysis showed that history of pancreatitis,pancreatic development and difficulty in intubation were risk factors for pancreatitis after ERCP surgery(P＜0.05).The results of decision tree model showed that history of pancreatitis,pancreatic development and intubation difficulties were all risk factors for postoperative pancreatitis after ERCP.The classification accuracy of logistic regression and decision tree model was 85.37％and 90.72％,respectively.ROC curve results showed that the area under the curve of logistic regression was 0.798,and the area under the curve of decision tree model was 0.843(P＜0.05).Conclusion Clinical treatment and intervention can be effective for patients with a history of pancreatitis,pancreatic development and difficulty in intubation complicated with lower segment cholangiocarcinoma and bile duct occupying.In addition,the combined application of logistic regression and decision tree method can find the influencing factors of postoperative pancreatitis in patients with lower segment cholangiocarcinoma complicated with bile duct space occupation from different levels,so as to strengthen early assessment and identification,and further reduce the risk of postoperative acute pancreatitis after ERCP.
logistic regressiondecision tree methodbile duct spaceendoscopic retrograde cholangiopancreatographypancre-atitis
万方数据
维普
