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全膝关节置换术后住院时间预测模型的构建与比较:基于新加坡单一中心1826例病例的回归模型与机器学习分析

Construction and Comparison of Predictive Models for Length of Stay after Total Knee Arthroplasty: Regression Model and Machine Learning Analysis Based on 1,826 Cases in a Single Singapore Center.

作者信息

Li Hui, Jiao Juyang, Zhang Shutao, Tang Haozheng, Qu Xinhua, Yue Bing

机构信息

Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.

出版信息

J Knee Surg. 2022 Jan;35(1):7-14. doi: 10.1055/s-0040-1710573. Epub 2020 Jun 8.

Abstract

The purpose of this study was to develop a predictive model for length of stay (LOS) after total knee arthroplasty (TKA). Between 2013 and 2014, 1,826 patients who underwent TKA from a single Singapore center were enrolled in the study after qualification. Demographics of patients with normal and prolonged LOS were analyzed. The risk variables that could affect LOS were identified by univariate analysis. Predictive models for LOS after TKA by logistic regression or machine learning were constructed and compared. The univariate analysis showed that age, American Society of Anesthesiologist level, diabetes, ischemic heart disease, congestive heart failure, general anesthesia, and operation duration were risk factors that could affect LOS ( < 0.05). Comparing with logistic regression models, the machine learning model with all variables was the best model to predict LOS after TKA, of whose area of operator characteristic curve was 0.738. Machine learning algorithms improved the predictive performance of LOS prediction models for TKA patients.

摘要

本研究的目的是建立全膝关节置换术(TKA)后住院时间(LOS)的预测模型。2013年至2014年期间,来自新加坡单一中心的1826例行TKA的患者在符合条件后纳入研究。分析了住院时间正常和延长的患者的人口统计学特征。通过单因素分析确定可能影响住院时间的风险变量。构建并比较了通过逻辑回归或机器学习得到的TKA后住院时间的预测模型。单因素分析表明,年龄、美国麻醉医师协会分级、糖尿病、缺血性心脏病、充血性心力衰竭、全身麻醉和手术时间是可能影响住院时间的风险因素(<0.05)。与逻辑回归模型相比,包含所有变量的机器学习模型是预测TKA后住院时间的最佳模型,其受试者工作特征曲线面积为0.738。机器学习算法提高了TKA患者住院时间预测模型的预测性能。

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