医学新知2024,Vol.34Issue(1) :14-24.DOI:10.12173/j.issn.1004-5511.202311014

住院老年患者轻度认知功能障碍风险预测模型的构建

Construction of the risk predition model of mild cognitive impairment in hospitalized elder patients

吴瑞凯 马龙 周晓辉 韩正风
医学新知2024,Vol.34Issue(1) :14-24.DOI:10.12173/j.issn.1004-5511.202311014

住院老年患者轻度认知功能障碍风险预测模型的构建

Construction of the risk predition model of mild cognitive impairment in hospitalized elder patients

吴瑞凯 1马龙 1周晓辉 2韩正风2
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作者信息

  • 1. 新疆医科大学公共卫生学院(乌鲁木齐 830011)
  • 2. 新疆医科大学第一附属医院老年医学科(乌鲁木齐 830054)
  • 折叠

摘要

目的 探讨住院老年患者轻度认知功能障碍(mild cognitive impairment,MCI)的影响因素,构建并比较多组MCI相对风险预测模型.方法 采用方便抽样法,选择2023年1月至2023年9月在新疆医科大学第一附属医院老年医学科住院的老年患者,构建Logistic回归预测模型、决策树预测模型、神经网络预测模型并分析MCI的影响因素,采用受试者工作特征曲线(receiver operating characteristic,ROC)下面积(area under curve,AUC)比较三组预测模型的效能.结果 共纳入住院老年患者 992 例,MCI检出率为21.17%.多因素Logistic回归模型、决策树模型、神经网络模型分析结果均显示年龄、脑血管病、文化程度为MCI的主要影响因素,多因素Logistic回归模型和神经网络模型还显示日常生活能力也是MCI的影响因素.多因素Logistic回归预测模型预测正确率为89.1%,ROC曲线下面积AUC为 0.933[95%CI(0.916,0.950)],灵敏度为 0.881,特异度为0.852,约登指数为0.733.决策树预测模型预测正确率为86.1%,AUC为0.908[95%CI(0.888,0.927)],灵敏度为 0.919,特异度为 0.753,约登指数为 0.672.神经网络预测模型预测正确率为 88.7%,AUC为 0.933[95%CI(0.915,0.950)],灵敏度为 0.876,特异度为 0.861,约登指数为 0.737.三组模型预测结果均>70%,预测效能较好.结论 年龄增加,受教育年限短,患有脑血管病,日常生活能力下降会增加老年患者发生MCI的风险.多因素Logistic回归、决策树、神经网络多组模型可从不同层面挖掘MCI的影响因素,多模型的有效结合能更充分的了解不同因素之间的相互作用,为MCI的早期筛查和干预提供参考.

Abstract

Objective To explore the influencing factors of mild cognitive impairment(MCI)in hospitalized elderly people,construct and compare the relative risk prediction model of multi-group MCI.Methods A convenient sampling method was used to select the elderly hospitalized in the geriatrics department of the First Affiliated Hospital of Xinjiang Medical University from January 2023 to September 2023.The multivariate Logistic regression,decision tree and neural network were constructed,and the influencing factors of MCI were analyzed.The area under curve(AUC)of receiver operating characteristic(ROC)was adopted to compared the performance of three sets of prediction models.Results A total of 992 hospitalized elderly patients were included,and the detection rate of MCI was 21.17%.The analysis results of multivariate Logistic regression model,decision tree model and neural network model all showed that age,cerebrovascular disease and education level were the main influencing factors of MCI,and the multiple Logistic regression model and neural network model also showed that the score of daily living ability below 60 was also the influencing factors of MCI.The prediction accuracy of multivariate Logistic regression prediction model was 89.1%,the AUC of ROC curve was 0.933[95%CI(0.916,0.950)],the sensitivity was 0.881,the specificity was 0.852,and the Yoden index was 0.733.The prediction accuracy of decision tree prediction model was 86.1%,AUC was 0.908[95%CI(0.888,0.927)],the sensitivity was 0.919,the specificity was 0.753,and the Yoden index was 0.672.The prediction accuracy of the neural network model was 88.7%,the AUC was 0.933[95%CI(0.915,0.950)],the sensitivity was 0.876,the specificity was 0.861,and the Yoden index was 0.737.The prediction results of the three groups of models were more than 70%,and the prediction efficiency were good.Conclusion Increasing age,shorter years of education,cerebrovascular disease,and decreased ability to perform daily living increase the risk of MCI in older adults.Multivariate Logistic regression,decision tree and neural network models can fully explore the influencing factors of MCI from different levels,and the effective combination of multiple models can fully understand the interaction between different factors,providing references for early screening and intervention of MCI.

关键词

轻度认知功能障碍/多因素Logistic回归模型/决策树模型/神经网络模型/预测模型/老年人

Key words

Mild cognitive impairment/Multivariate Logistic regression model/Decision tree model/Neural network model/Prediction model/Elderly

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基金项目

国家自然科学基金联合基金项目(U1503223)

新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目(WJWY-202148)

新疆护理学会年度科研项目(2022XH16)

新疆护理学会年度科研项目(2023XH040)

新疆医科大学第一附属医院"青年科研起航"专项(2022YFY-QNRC-07)

出版年

2024
医学新知
武汉大学中南医院,中国农工民主党湖北省委医药卫生工作委员会

医学新知

CSTPCD
影响因子:0.243
ISSN:1004-5511
参考文献量11
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