基于Apriori算法的心内科住院患者静脉血栓栓塞症危险因素分析

Analysis of risk factors for venous thrombus embolism in cardiology inpatients based on the Apriori algorithm

目的分析心内科住院患者静脉血栓栓塞症(venous thrombus embolism,VTE)的发生现状及危险因素,为构建心内科专科VTE风险预测模型提供依据。方法回顾性分析175例在广东省某三甲医院心血管内科住院期间确诊VTE的患者的临床资料,基于关联规则Apriori算法探究VTE发生的危险因素及各危险因素间的关联性。结果发生VTE的患者中,单纯深静脉血栓形成(deep venous thrombosis,DVT)占比最高(81.71%),其次为单纯肺血栓栓塞(pulmonary thromboembolism,PTE;10.29%),DVT合并PTE最低(8.00%)。关联规则结果显示,心内科住院患者VTE发生的前9项危险因素依次为留置中心静脉导管、心功能Ⅲ级或Ⅳ级、急性心肌梗死、血小板计数异常、心力衰竭、房颤、住院期间使用过利尿剂、冠心病及卧床时间>72 h。结论本研究通过关联规则分析发现了心内科住院患者发生VTE的危险因素之间的关联特点,提示护理人员应重点关注留置中心静脉导管、原发疾病为VTE危险因素、心功能Ⅲ级或Ⅳ级、血小板计数异常、住院期间使用过利尿剂及合并多项以上危险因素的患者,并制订相应的个体化血栓预防措施,从而降低VTE发生风险。

Objective To analyze the current status and risk factors for venous thrombus embolism(VTE)in inpatients in the cardiology department,so as to provide a basis for constructing a specialized VTE risk prediction model.Methods A retrospective analysis of clinical data from 175 patients diagnosed with VTE during their hospitalization in a tertiary hospital in Guangdong province was conducted,and the Apriori algorithm for association rule mining was used to explore the risk factors for VTE occurrence and the associations between these factors.Results Among patients who developed VTE,deep venous thrombosis(DVT)accounted for the highest proportion(81.71%),followed by pulmonary thromboembolism(PTE,10.29%),and the lowest proportion of DVT combined with PTE(8.00%).The association rule results indicated that the top 9 risk factors for VTE occurrence in cardiology department inpatients were,in order,central venous catheter placement,cardiac function classⅢorⅣ,acute myocardial infarction,abnormal platelet count,heart failure,atrial fibrillation,diuretic use during hospitalization,coronary artery disease,and bed rest time>72 hours.Conclusion The correlation characteristics among risk factors for VTE in cardiology inpatients are identified through association rule analysis in this study,which suggests that nursing staff should pay special attention to patients with the presence of a central venous catheter,the primary disease being a risk factor for VTE,cardiac function classⅢorⅣ,abnormal platelet count,diuretic use during hospitalization,and the coexistence of multiple aforementioned risk factors.Individualized thromboprophylaxis measures should be developed accordingly to reduce the risk of VTE occurrence.