lasso-logistic回归模型在经皮肾镜碎石取石术后感染性休克影响因素分析中的应用

Application of lasso-logistic model in the analysis of septic shock influencing factors after percutaneous nephrolithotripsy

目的旨在基于lasso的logistic回归变量选择方法对经皮肾镜碎石取石术后感染性休克影响因素进行分析,为减少感染性休克的发生提供有价值的指导。方法回顾性分析2009年3月至2020年1月在温州市中心医院行经皮肾镜碎石取石术的802例患者临床资料,应用lasso-logistic回归模型筛选经皮肾镜碎石取石术后发生感染性休克的影响因素,通过交叉验证法选择模型中的调和参数λ。采用赤池信息准则(AIC)和贝叶斯信息准则(BIC)比较lasso-logistic回归模型与全变量逐步logistic回归模型、逐步logistic回归模型的拟合精度和预测效果。结果lasso-logistic回归分析显示性别、结石大小、术前尿培养、血红蛋白下降值以及手术时间是经皮肾镜碎石取石术后感染性休克发生的影响因素。lasso-logistic回归模型的AIC以及BIC分别为143.747和169.854,均低于全变量逐步logistic回归模型、逐步logistic回归模型。结论基于性别、结石大小、术前尿培养、血红蛋白下降值以及手术时间等5个因素建立的经皮肾镜碎石取石术后感染性休克lasso-logistic回归模型具有较好的拟合精度和预测效果。

Objective To analyze the influencing factors of septic shock after percutaneous nephrolithotomy based on lasso of logistic regression variable selection method,and provide valuable guidance for reducing the occurrence of septic shock.Methods The clinical data of 802 patients who underwent percutaneous nephrolithotripsy in Wenzhou Central Hospital from March 2009 to January 2020 were retrospectively analyzed.Lasso logistic model was performed to identify the influencing factors of septic shock after percutaneous nephrolithotomy.Cross validation method was used to chooseλfor lasso-logistic model.In addition,the fitting accuracy and prediction effect of lasso-logistic regression model,full-variable logistic regression model and stepwise logistic regression model were compared using Akaike Information Criterion(AIC)and Bayesian Information Criterion(BIC).Results Lasso-logistic regression model showed that sex,stone size,preoperative urine culture,decrease in hemoglobin,and operation time were independent influencing factors of septic shock after percutaneous nephrolithotomy.The AIC and BIC of lasso-logistic regression model were 143.747 and 169.854,respectively,which were lower than those of full-variable logistic regression model and stepwise logistic regression model.Conclusion Lasso-logistic regression model of septic shock after percutaneous nephrolithotomy based on the above five factors has good fitting accuracy and predictive effect.