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Logistic 回归和决策树模型在预测脑卒中患者日常生活活动能力中的应用。

Application of Logistic Regression and Decision Tree Models in the Prediction of Activities of Daily Living in Patients with Stroke.

机构信息

Department of Rehabilitation, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China.

The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.

出版信息

Neural Plast. 2022 Jan 28;2022:9662630. doi: 10.1155/2022/9662630. eCollection 2022.

Abstract

An improvement in the activities of daily living (ADLs) is significantly related to the quality of life and prognoses of patients with stroke. However, the factors predicting significant improvement in ADL (SI-ADL) have not yet been clarified. Therefore, we sought to identify the key factors affecting SI-ADL in patients with stroke after rehabilitation therapy using both logistic regression modeling and decision tree modeling. We retrospectively collected and analyzed the clinical data of 190 patients with stroke who underwent rehabilitation therapy at our hospital between January 2020 and July 2020. General and rehabilitation therapy data were extracted, and the Barthel index (BI) score was used for outcome assessment. We defined SI-ADL as an improvement in the BI score by 15 points or more during hospitalization. Logistic regression and decision tree models were established to explore the SI-ADL predictors. We then used receiver operating characteristic (ROC) curves to compare the logistic regression and decision tree models. Univariate analysis revealed that compared with the non-SI-ADL group, the SI-ADL group showed a significantly shorter course of stroke, longer hospital stay, and higher rate of receiving occupational and speech therapies (all < 0.05). Binary logistic regression analysis revealed the course of stroke at admission (odds ratio (OR) = 0.986, 95%confidence interval (CI) = 0.979-0.993; < 0.001) and the length of hospital stay (OR = 1.030, 95%CI = 1.013-1.047;  =0.001) as the independent predictors of SI-ADL. ROC comparisons revealed no significant differences in the areas under the curves for the logistic regression and decision tree models (0.808 0.831; = 0.977, = 0.329). Both models identified the course of disease at admission and the length of hospital stay as key factors affecting SI-ADL. Early initiation of rehabilitation therapy is of immense importance for improving the ADLs in patients with stroke.

摘要

日常生活活动(ADL)的改善与脑卒中患者的生活质量和预后密切相关。然而,预测 ADL 显著改善(SI-ADL)的因素尚未明确。因此,我们试图使用逻辑回归建模和决策树建模来确定影响脑卒中患者康复治疗后 SI-ADL 的关键因素。我们回顾性收集并分析了 2020 年 1 月至 2020 年 7 月在我院接受康复治疗的 190 例脑卒中患者的临床资料。提取一般资料和康复治疗资料,采用 Barthel 指数(BI)评分进行结局评估。我们将 SI-ADL 定义为住院期间 BI 评分提高 15 分或以上。建立逻辑回归和决策树模型来探讨 SI-ADL 的预测因素。然后,我们使用受试者工作特征(ROC)曲线比较逻辑回归和决策树模型。单因素分析显示,与非 SI-ADL 组相比,SI-ADL 组的脑卒中病程更短、住院时间更长、接受职业治疗和言语治疗的比例更高(均 < 0.05)。二元逻辑回归分析显示,入院时脑卒中病程(比值比(OR)=0.986,95%置信区间(CI)=0.979-0.993; < 0.001)和住院时间(OR=1.030,95%CI=1.013-1.047;  =0.001)是 SI-ADL 的独立预测因素。ROC 比较显示,逻辑回归和决策树模型的曲线下面积无显著差异(0.808 0.831; = 0.977, = 0.329)。两个模型均将发病时的病程和住院时间确定为影响 SI-ADL 的关键因素。早期开始康复治疗对改善脑卒中患者的 ADL 非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a69/8816537/00002f1f3d24/NP2022-9662630.001.jpg

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