基于决策树模型的中西结合诊疗模式下新型冠状病毒感染住院患者死亡风险因素分析

Analysis of Factors Associated with Disease Outcomes in Hospitalized Patients with COVID-19Under Integrated Chinese and Western Diagnosis and Treatment Model:Based on Decision Tree Model

目的:应用决策树构建预测模型探索中西结合诊疗模式下新型冠状病毒感染住院患者死亡风险因素。方法:以武汉市某定点医院2020年3月20日以前收治的所有新型冠状病毒感染确诊病例为主要研究对象,按是否发生住院期间死亡分为两组,采用χ^(2)检验或Mann-Whitney U进行单因素检验,筛选出两组间差异有统计学意义的因素,通过共线性筛选排除具有潜在共线性的因素,剩余因素被纳入构建决策树模型,采用决策树算法建立新型冠状病毒感染住院患者的死亡预测模型,并对其预测准确性进行评估。结果:应用决策树模型筛选出危重型患者、降钙素原、中药汤剂、淋巴细胞绝对值、中成药等5个预测因素,经验证集验证,该模型的正确率为95.4%,表明模型预测性良好。结论:通过采集272例患者信息构建了中西医结合诊疗模式下新型冠状病毒感染住院患者死亡风险因素的预测模型,其中危重型比例、降钙素原升高、淋巴细胞绝对值降低是增加住院患者死亡风险的危险因素,而使用中药汤剂和中成药是降低患者死亡风险的保护因素。

Objective:Using the decision tree model to explore the death risk factors of hospitalized patients with COVID-19under the integrated Chinese and Western diagnosis and treatment model.Methods:Taking all confirmed cases of COVID-19admitted before March 20,2020 in a designated hospital in Wuhan as the main research object,they are divided into two groups according to the occurrence of death during hospitalization,and the chi-square test or Mann-Whitney U is used for single factor The test selects the factors with statistical significance between the two groups.The factors with potential collinearity were excluded through collinearity screening and the remaining factors were included in the construction of the decision tree model.The decision tree algorithm was used to establish the death prediction of patients with new coronavirus pneumonia.Model and evaluate its prediction accuracy.Results:The decision tree model screened out five predictive factors:criticality ratio,procalcitonin,traditional Chinese medicine decoction,absolute lymphocyte value and Chinese patent medicine.After verification set verification,the accuracy of this model was 95.4%,indicating that the model has good predictability.Conclusion:Based on the information of 272patients,this study constructed a prediction model for the death risk factors of hospitalized patients with COVID-19under the integrated diagnosis and treatment model of Chinese and Western medicine.The proportion of critically ill patients,increased procalcitonin and decreased absolute value of lymphocytes are risk factors that increase the risk of death in hospitalized patients,traditional Chinese medicine decoctions and proprietary Chinese medicines are protective factors to reduce the risk of death.