成人住院患者非计划拔管数据挖掘与分析

Data mining and analysis of unplanned extubation in adult inpatients

目的:找出成人住院患者非计划拔管事件中隐含的、有价值的关联规则,为制订预防非计划拔管方案提供参考。方法:采集杭州市某三级甲等医院2016年1月至2020年12月期间618例发生非计划拔管患者的42024项数据,采用Apriori算法进行数据挖掘,使用卡方检验对得到的关联规则进行有效性评定,最后结合专家组分析获取强关联规则。结果:共获取强关联规则13对。住院患者非计划拔管事件中的高风险因素包括男性、意识状态清醒、吸烟史、无职业、无约束、低风险导管、非静脉导管、导管固定形式单一、夜间时段、当班护士工作年限1~3年。结论:应重点关注男性、有吸烟史、无职业、无约束患者的非计划拔管风险,加强对夜间时段、低风险导管、非静脉导管的管理,做好对低年资护士的相关培训工作。

Objective:To discover the potential associations between the unplanned extubation and other factors in adult inpatients,and to provide reference for the prevention plans of unplanned extubation.Methods:Totally 42024 items data from 618 patients with unplanned extubation in a tertiary grade A hospital in Hangzhou from January 2016 to December 2020 were collected.Apriori algorithm was used for data mining,chi-square test was used to evaluate the validity of the obtained potential association rules,and the strong association rules were formed combining with the opinions of experts and the results of data analysis.Results:A total of 13 pairs of strong association rules were formed.The high-risk predictors in unplanned extubation in adult inpatients include:male,conscious state,with smoking history,no occupation,no restraint,with low-risk catheter,non-venous catheter,single catheter fixation,night time,the working years of nurse on duty were 1-3 years.Conclusion:More attention should be paid to the male,those with smoking history,non-employment,and unconstrained,and the management of nighttime,low-risk catheters,and non-venous catheters,and training for low-age nurses also are important.