Wang Jirui, Zhao Defeng, Lin Meiqing, Huang Xinyu, Shang Xiuli
Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China.
The First Clinical Department, China Medical University, Shenyang, China.
Front Aging Neurosci. 2021 Jun 25;13:657937. doi: 10.3389/fnagi.2021.657937. eCollection 2021.
Post-stroke anxiety (PSA) has caused wide public concern in recent years, and the study on risk factors analysis and prediction is still an open issue. With the deepening of the research, machine learning has been widely applied to various scenarios and make great achievements increasingly, which brings new approaches to this field. In this paper, 395 patients with acute ischemic stroke are collected and evaluated by anxiety scales (i.e., HADS-A, HAMA, and SAS), hence the patients are divided into anxiety group and non-anxiety group. Afterward, the results of demographic data and general laboratory examination between the two groups are compared to identify the risk factors with statistical differences accordingly. Then the factors with statistical differences are incorporated into a multivariate logistic regression to obtain risk factors and protective factors of PSA. Statistical analysis shows great differences in gender, age, serious stroke, hypertension, diabetes mellitus, drinking, and HDL-C level between PSA group and non-anxiety group with HADS-A and HAMA evaluation. Meanwhile, as evaluated by SAS scale, gender, serious stroke, hypertension, diabetes mellitus, drinking, and HDL-C level differ in the PSA group and the non-anxiety group. Multivariate logistic regression analysis of HADS-A, HAMA, and SAS scales suggest that hypertension, diabetes mellitus, drinking, high NIHSS score, and low serum HDL-C level are related to PSA. In other words, gender, age, disability, hypertension, diabetes mellitus, HDL-C, and drinking are closely related to anxiety during the acute stage of ischemic stroke. Hypertension, diabetes mellitus, drinking, and disability increased the risk of PSA, and higher serum HDL-C level decreased the risk of PSA. Several machine learning methods are employed to predict PSA according to HADS-A, HAMA, and SAS scores, respectively. The experimental results indicate that random forest outperforms the competitive methods in PSA prediction, which contributes to early intervention for clinical treatment.
近年来,中风后焦虑(PSA)引起了广泛的公众关注,对其危险因素分析和预测的研究仍然是一个未解决的问题。随着研究的深入,机器学习已广泛应用于各种场景并日益取得巨大成就,这为该领域带来了新的方法。本文收集了395例急性缺血性中风患者,并通过焦虑量表(即医院焦虑抑郁量表-焦虑亚量表(HADS-A)、汉密尔顿焦虑量表(HAMA)和焦虑自评量表(SAS))进行评估,从而将患者分为焦虑组和非焦虑组。之后,比较两组之间的人口统计学数据和一般实验室检查结果,以确定具有统计学差异的危险因素。然后将具有统计学差异的因素纳入多因素逻辑回归分析,以获得PSA的危险因素和保护因素。统计分析表明,在使用HADS-A和HAMA评估时,PSA组和非焦虑组在性别、年龄、重度中风、高血压、糖尿病、饮酒和高密度脂蛋白胆固醇(HDL-C)水平方面存在很大差异。同时,以SAS量表评估,PSA组和非焦虑组在性别、重度中风、高血压、糖尿病、饮酒和HDL-C水平方面存在差异。对HADS-A、HAMA和SAS量表进行多因素逻辑回归分析表明,高血压、糖尿病、饮酒、美国国立卫生研究院卒中量表(NIHSS)评分高和血清HDL-C水平低与PSA有关。换句话说,性别、年龄、残疾、高血压、糖尿病、HDL-C和饮酒与缺血性中风急性期的焦虑密切相关。高血压、糖尿病、饮酒和残疾增加了PSA的风险,而较高的血清HDL-C水平降低了PSA的风险。分别采用几种机器学习方法根据HADS-A、HAMA和SAS评分预测PSA。实验结果表明,随机森林在PSA预测方面优于其他竞争方法,这有助于临床治疗的早期干预。