[基于费舍尔判别分析构建中暑患者死亡风险预警模型]。

E M Ma, K Lu, Y B Wei
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摘要

目的建立评估中暑患者死亡风险的预警模型。方法选取 2016 年 1 月至 2020 年 12 月鄯善县综合重症监护室收治的中暑患者病例资料。根据患者的短期疗效(28 天)将其分为死亡组(20 例)和存活组(53 例)。选取入院后 24 小时内各组间差异有统计学意义的相关指标。通过绘制受试者工作曲线(ROC)并计算曲线下面积,选择曲线下面积大于 0.7 的相关指标,采用 Fisher 判别分析建立中暑死亡风险评估模型。收集2021年1月1日至2022年12月鄯善县综合ICU中暑患者数据进行外业验证。结果 各组患者的年龄、胱抑素C、降钙素原、血小板计数、CKMB、CK、CREA、PT、TT、APTT、心率、呼吸频率、GLS评分均有明显差异。入院时胱抑素 C、CKMB、CREA、PT、TT、心率 AUC 面积大于 0.7。采用费雪分析法建立功能模型。结果功能模型的诊断灵敏度、特异性和 AUC 面积分别为 95%、83% 和 0.937。外部验证结果显示,预测生存组的准确率为 85.71%,预测死亡组的准确率为 88.89%。结论通过ROC曲线分析和Fisher判别分析构建的中暑死亡预警模型可为中暑的早期干预提供客观参考。
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[Constructing an early-warning model for mortality risk in heat stroke patients based on Fisher discriminant analysis].

Objective: To establish an early warning model to assess the mortality risk of patients with heat stroke disease. Methods: The case data of patients diagnosed with heat stroke disease admitted to the comprehensive ICU of Shanshan County from January 2016 to December 2020 were selected. According to the short-term outcome (28 days) of patients, they were divided into death group (20 cases) and survival group (53 cases) . The relevant indicators with statistically significant differences between groups within 24 hours after admission were selected. By drawing the subject work curve (ROC) and calculating the area under the curve, the relevant indicators with the area under the curve greater than 0.7 were selected, Fisher discriminant analysis was used to establish an assessment model for the death risk of heat stroke disease. The data of heat stroke patients from January 1, 2021 to December 2022 in the comprehensive ICU of Shanshan County were collected for external verification. Results There were significant differences in age, cystatin C, procalcitonin, platelet count, CKMB, CK, CREA, PT, TT, APTT, heart rate, respiratory rate and GLS score among the groups. Cystatin C, CKMB, CREA, PT, TT, heart rate AUC area at admission was greater than 0.7. Fisher analysis method is used to build a functional model. Results: The diagnostic sensitivity, specificity and AUC area of the functional model were 95%, 83% and 0.937 respectively. The external validation results showed that the accuracy of predicting survival group was 85.71%, the accuracy of predicting death group was 88.89%. Conclusion: The early warning model of heat stroke death constructed by ROC curve analysis and Fisher discriminant analysis can provide objective reference for early intervention of heat stroke.

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来源期刊
中华劳动卫生职业病杂志
中华劳动卫生职业病杂志 Medicine-Medicine (all)
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9764
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