Risk Factors for Birth Defects: A Conditional LogisticRegression Analysis of a Case-Control Study in Guang-dong Province of China

Information was obtained from the same questionnaire (23 risk factors listed) of cases and controls. We used a multivariate logistic model, which described variables significantly increased risk of birth defects. The risk factors included maternal educational levels, medicine taken during pregnancy and antenatal care. It was suggested to strengthen antenatal care was the main preventive measure against birth defects.

Logistic Regression Analysis the Risk Factors of Peripherally Inserted Central Catheter Related Blood Stream Infection of Tumor Patients

Objective: Our object is to study risk factors of tumor patients’ PICC catheter-related blood stream infection. Method: a retrospective analysis of data of 586 PICC catheterized patients was implemented, a univariate analysis of general data and catheterizing data of tumor patients was then carried out, and data of single factors with statistical significance were incorporated into multi-factor Logistic regression model for analysis. Results: PICC catheter-related blood stream infection occurred to 16 patients, and occurrence rate was 2.73%. Multi-factor Logistic regression analysis results showed that number of puncturing times, positioning method and maintenance frequency were risk factors for tumor patients’ peripherally inserted central catheter catheter-related blood stream infection, and odds risk values were respectively 8.762, 9.253 and 10.324. Conclusion: for tumor patients implanted with peripherally inserted central catheters, using ECG positioning during strict sterile operation and catheterizing process to avoid repeated puncturing and increasing maintenance frequency could effectively reduce occurrence of PICC catheter-related blood stream infection.

Analysis of Cardiovascular Risk Factors in Newly Defined Stage 1 Hypertension among Chinese on the Basis of the 2017 ACC/AHA Hypertension Guidelines

In 2017,American College of Cardiology(ACC)/American Heart Association(AHA)et al.jointly released the latest guidelines for adult hypertension,exactly including prevention,diagnosis,assess and treatment,in which blood pressure levels greater than 130/80 mm Hg were defined as hypertension[1].Based on these modified guidelines,the morbidity of hypertension in US increased from 32%to 46%.

Logistics Regression Analysis between TCM Constitution Types of Patients with Hypertension,Insomnia and ABPM,PSQI

[Objectives]The research aimed to explore the distribution characteristics of TCM constitution types of patients with hypertension and insomnia,and study the clinical characteristics of patients with different constitutions,in order to provide new ideas for the treatment of patients with hypertension and insomnia.[Methods]Cross sectional observation method was used,and 420 patients with hypertension and insomnia were selected.Required information was collected,and the constitution type of traditional Chinese medicine was determined,and relevant data were recorded.SPSS and Logistic regression analysis method were used to explore the correlation between the distribution of TCM constitution types and gender,age,24 h-SBP,24 h-DBP,24 h-BPV,PSQI score,etc.[Results]Among 420 patients,the proportion of gentleness constitution was the most,and others in turn were Qi deficiency constitution>Yang deficiency constitution>phlegm dampness constitution>Qi stagnation constitution>Yin deficiency constitution>blood stasis constitution>damp heat constitution>special constitution.Among male patients,the proportion of gentleness constitution was the most.Among female patients,the proportion of Qi deficiency constitution was the most.In each constitution,the proportion of men and women was different,and the difference in gentleness constitution,Qi deficiency constitution and Yin deficiency constitution had statistical significance(P<0.05).The proportion of gentleness constitution for young and middle-aged patients was the most,while elderly patients with Qi deficiency constitution was the most.There was difference in the distribution of TCM constitution in different age groups,and the difference had statistical significance(P<0.05).Compared with the patients with gentleness constitution,the patients with Qi deficiency constitution,Yang deficiency constitution,Yin deficiency constitution,damp heat constitution,blood stasis constitution and Qi stagnation constitution had different differences in terms of age,24 h-SBP,24 h-DBP,24 h-BPV and PSQI score,and there was statistical significance(P<0.05).Except damp heat constitution,blood stasis constitution and special constitution,other constitutions had certain correlation with age,24 h-SBP,24 h-DBP,24 h-BPV and PSQI score.[Conclusions]TCM constitution types of patients with hypertension and insomnia were dominant by gentleness constitution,Qi deficiency constitution and Yang deficiency constitution.The distribution of TCM constitution in different gender and age groups was different,and different TCM constitution was related to ABPM and PSQI.

Logistic Regression Analysis of Influencing Factors on Serum ALT and HCV RNA Changes in Patients with Chronic Hepatitis C

Objective This study was undertaken to investigate the influencing factors on serum ALT level and hepatitis C virus(HCV)RNA titer in chronic hepatitis C(CHC)patients.Methods All patients enrolled into this study were anti-HCV positive.Retrospective tracing method was applied to detect serum ALT level and HCV RNA titer and to collect general information of the patients such as genders,age groups,interferon medication history,infection pathways,height and weight.Then the multi-factor analysis was adopted with the application of binominal logistic regression mode.Results The abnormal rate of ALT level was positively correlated to HCV RNA and gender while negatively correlated to interferon medication history and age group,with Wald value of the 4 factors as 39.604,11.823,18.991 and 7.389,respectively.The positive rate of HCV RNA was negatively correlated to interferon medication history and gender while positively correlated to ALT level,with corresponding Wald value of the 3 factors as81.394,7.618 and 27.562,respectively.Conclusions The normal ALT level in HCV infected patients was associated with viral load,age,gender and interferon medication history,while the normal rate of HCV RNA titer was closely associated with gender,interferon medication history and ALT level.

影响结核性胸腔积液并发胸膜增厚的非条件Logistic回归分析

目的探讨影响结核性胸腔积液并发胸膜增厚的相关危险因素。方法回顾性分析2019年1月至2021年3月广州市胸科医院呼吸内科收治的123例结核性胸腔积液患者的临床资料,统计患者胸膜增厚情况,采用单因素及非条件Logistic回归法分析患者胸膜增厚的影响因素。结果胸膜未增厚与胸膜增厚患者性别、年龄、肺结核、胸水分布、用力肺活量(FVC)、第1秒用力呼气容积(FVE1)/FVC、胸水腺苷脱氨酶(ADA)、血清ADA、胸水白细胞、胸水淋巴细胞、胸水中性粒细胞和淋巴细胞比例比较差异无统计学意义;胸膜未增厚与胸膜增厚患者胸水量、胸水吸收时间、FVE1、胸水乳酸脱氢酶(LDH)、血清LDH、胸水蛋白、血清蛋白比较差异有统计学意义(P<0.05)。Logistic回归分析结果显示,胸水量(中大量)、FVE1、胸水LDH、血清LDH、胸水蛋白及血清蛋白是胸膜增厚发生的危险因素(P<0.05)。结论结核性胸腔积液并发胸膜增厚是多因素作用的结果,胸水量、FVE1、胸水吸收时间、胸水LDH、血清LDH、胸水蛋白和血清蛋白与胸膜增厚的发生密切相关,建议临床予以密切监测并积极采取针对性干预措施。

105例不孕症患者子宫输卵管造影结果影响因素的Logistic回归分析

目的探讨不孕症患者子宫输卵管造影结果发生异常的影响因素。方法选取2021年1月至2023年5月在湖南中医药大学第二附属医院妇科门诊就诊并接受X线子宫输卵管造影(X-ray hysterosalpingography,X-HSG)检查的105例不孕症患者,收集患者临床资料包括年龄、月经周期、不孕症类型、支原体感染史、衣原体感染史、淋病奈瑟球菌感染史、盆腔炎相关病史、输卵管相关病史等,并填写《中医体质调查问卷表》,采用Logistic回归方程分析不孕症患者X-HSG结果的影响因素。结果X-HSG结果异常与盆腔炎相关病史、输卵管相关病史、年龄、气郁质及湿热质呈正相关(P<0.05),与不孕症类型、月经周期规律与否无相关性(P>0.05)。多因素Logistic回归分析结果显示:不孕症类型、月经周期、气郁质、湿热质是HSG发生异常的危险因素(OR>1),年龄、盆腔炎相关病史、输卵管相关病史是HSG发生异常的保护因素(OR<1)。结论适龄生育、减少盆腔炎相关病史、减少输卵管相关病史、调畅情志、忌食肥甘厚味对于减少输卵管病理损伤引起的不孕症至关重要。

Risk factors and care of early surgical site infection after primary posterior lumbar interbody fusion

Objectives:To explore the risk factors and nursing measures of early surgical site infection(SSI)after posterior lumbar interbody fusion(PLIF).Methods:A total of 468 patients who received PLIF in our hospital from January 2017 to June 2020 were enrolled into this study.According to the occurrence of early SSI,the patients were divided into two groups,and the general data were analyzed by univariate analysis.Multivariate logistic regression analysis was conducted with the dichotomous variable of whether early SSI occurred and other factors as independent variables to identify the risk factors of early SSI and put forward targeted prevention and nursing measures.Results:Among 468 patients with PLIF,18 patients developed early SSI(3.85%).The proportion of female,age,diabetes mellitus and urinary tract infection(UTI),operation segment,operation time,post-operative drainage volume,and drainage time were significantly higher than those in the uninfected group,with statistical significance(P<0.05),whereas the preoperative albumin and hemoglobin in the infected group were significantly lower than those in the uninfected group,with statistical significance(P<0.05).There was no significant difference between the two groups in the American Society of Anesthesiologists(ASA)grading,body mass index(BMI),complications including cardiovascular and cerebrovascular diseases or hypertension(P>0.05).Logistic regression analysis showed that preoperative diabetes mellitus(OR=2.109,P=0.012)/UTI(OR=1.526,P=0.035),prolonged drainage time(OR=1.639,P=0.029)were risk factors for early SSI.Men(OR=0.736,P=0.027)and albumin level(OR=0.526,P=0.004)were protective factors in reducing early SSI.Conclusions:Women,preoperative diabetes/UTI,hypoproteinemia,and prolonged drainage time are risk factors for early SSI after PLIF.Clinical effective preventive measures should be taken in combination with targeted nursing intervention to reduce the risk of early SSI.

基于Logistic回归和支持向量机的早发性结直肠癌风险预测模型

目的:通过Logis tic回归和支持向量机(SVM)探究早发性结直肠癌(EOCRC)和晚发性结直肠癌(LOCRC)的危险因素,建立针对不同年龄段人群的风险预测模型并比较预测效果。方法:选择2012—2022年诊断为结直肠癌患者,记录人口学特征、临床表现、既往史、家族史、生活方式、体格检查、实验室检查及病理诊断,分别建立风险预测模型,比较两模型的ROC曲线下面积(AUROC)、准确率、精确率、召回率、F1分数。结果:综合两模型结果,EOCRC风险与出现消化道出血、腹胀腹痛、大便习惯改变等临床表现、体重减轻、肿瘤标志物升高具有较强的正相关性,与婚姻状况、阑尾切除史、糖尿病史、血脂异常病史、结直肠癌家族史也存在较弱的正相关;LOCRC风险与婚姻状况、出现临床表现、体重减轻、血脂异常、肿瘤标志物升高具有较强的正相关性,与年龄、吸烟、阑尾切除史、结直肠癌家族史也存在一定的正相关性。两模型的AUROC、准确率、F1分数相差不大,但Logistic回归模型的精确率更高而SVM模型的召回率更高。结论:EOCRC和LOCRC的危险因素不完全相同,婚姻状况、吸烟、血脂异常、肿瘤家族史在EOCRC中的贡献低于在LOCRC中的贡献。相较Logistic回归,SVM能发现更多的结直肠癌危险因素,能尽可能多的找出结直肠癌的可能患者。

应用决策树和logistic回归模型分析胃肠道穿孔修补术后手术部位感染的影响因素

目的应用决策树和logistic回归模型分析胃肠道穿孔修补术后并发手术部位感染(SSI)的影响因素。方法选取2018年1月—2023年1月于绵阳市某医院进行胃肠道穿孔修补术的患者为研究对象,收集患者临床资料,根据术后是否发生SSI将患者分为SSI(+)组(n=41)和SSI(-)组(n=322)。使用单因素和多因素logistic回归分析胃肠道穿孔修补术后并发SSI的影响因素,并建立相关决策树预测模型。结果363例胃肠道穿孔修补术患者术后发生SSI 41例,发病率为11.29%。单因素分析结果显示,两组患者身体质量指数(BMI)、清蛋白水平、术前应用抗菌药物、术前腹痛时间和手术时间比较,差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示,BMI较高(OR=2.059,95%CI:1.103~3.842)、清蛋白水平<35 g/L(OR=2.761,95%CI:1.312~5.811)、术前腹痛时间≥24 h(OR=3.589,95%CI:1.659~7.763)和手术时间≥2 h(OR=3.314,95%CI:1.477~7.435)是胃肠道穿孔修补术后患者并发SSI的独立危险因素(P<0.05),术前应用抗菌药物是其保护因素(OR=0.338,95%CI:0.166~0.690,P<0.05)。基于上述因素建立预测胃肠道穿孔修补术后患者并发SSI风险的决策树模型。模型验证结果显示,受试者工作特征曲线下面积(AUC)为0.811(95%CI:0.794~0.825)。结论胃肠道穿孔修补术后患者并发SSI的危险因素包括BMI较高、清蛋白水平<35 g/L、术前腹痛时间≥24 h和手术时间≥2 h,保护因素为术前应用抗菌药物,基于影响因素构建的决策树模型对胃肠道穿孔修补术后患者并发SSI风险具有良好的预测能力。

基于logistic回归模型分析骨科手术部位感染的影响因素

目的总结骨科手术部位感染现状,探讨骨科手术部位感染的影响因素。方法收集江苏省盐城市第三人民医院2022年1月至2023年12月骨科手术部位感染病例作为感染组,共41例,按照1∶1的比例,随机抽取同科室2022年1月至2023年12月年龄相近(±10岁)、性别相同未发生手术部位感染的41例病例作为非感染组,分析骨科手术部位感染病原菌分布情况并基于二分类logistic回归模型分析骨科手术部位感染的影响因素。结果本研究共纳入41例手术部位感染患者,术后1~3 d发生手术部位感染10例(24.39%),术后4~6 d发生手术部位感染12例(29.27%),术后7~9 d发生手术部位感染5例(12.20%),术后10~30 d发生手术部位感染10例(24.39%),术后31~90 d发生手术部位感染4例(9.76%)。感染组检出40株病原菌,主要为革兰氏阳性球菌(31株,77.50%),最常见的为金黄色葡萄球菌(19株,47.50%),其次为凝固酶阴性葡萄球菌(7株,17.50%)。两组糖尿病史、体重指数(BMI)、术前纤维蛋白原、手术持续时间、手术引流比较,差异有统计学意义(P<0.05)。logistic回归分析显示,患者BMI(OR=1.231,95%CI:1.049~1.445,P=0.011)是骨科手术部位感染的独立危险因素。BMI作为手术部位感染的独立危险因素,其临界值为25.37 kg/m2。结论骨科手术患者中,肥胖患者更易发生手术部位感染,建议进一步强化肥胖患者的围手术期管理,以减少手术部位感染的发生。

随机森林模型和Logistic回归模型预测非计划再手术发生风险的效能比较

目的比较随机森林模型和Logistic回归模型预测非计划再手术发生风险的效能。方法在手术麻醉系统中筛选一次住院期间申请2次手术的患者信息。提取所有非计划再次手术患者(n=219)作为研究组,对应科室的计划再次手术患者(n=14311)作为对照组。运用随机森林模型和Logistic回归模型建立非计划再手术预测模型。采用受试者工作特征曲线下面积评价两种模型的预测效能。结果(1)Logistic回归分析结果显示,前次术中输血、罹患恶性肿瘤、合并疾病数量、前次手术切口愈合等级、前次手术级别、前次手术时长、前次手术切口类别是非计划再手术发生的影响因素(P<0.05)。Logistic回归预测模型的曲线下面积为0.922,灵敏度、特异度、准确率分别为92.59%、79.11%、79.28%。(2)随机森林模型特征变量的重要性排序结果显示,前次手术切口类别、前次术中输血、前次手术级别、前次手术切口愈合等级、合并疾病数量、罹患恶性肿瘤等变量的重要性更靠前。随机森林预测模型的曲线下面积为0.866,灵敏度、特异度、准确率分别为80.00%、93.33%、86.66%。Logistic回归预测模型曲线下面积大于随机森林预测模型,但差异无统计学意义(P>0.05)。结论综合使用Logistic回归模型和随机森林模型,并将二者分析结果互为补充,可从各个方面预测非计划再次手术的风险因素,能获得更好的预测效能。

Risk factors of concurrent urinary sepsis in patients with diabetes mellitus comorbid with upper urinary tract calculi

BACKGROUND Urinary sepsis is frequently seen in patients with diabetes mellitus(DM)complicated with upper urinary tract calculi(UUTCs).Currently,the known risk factors of urinary sepsis are not uniform.AIM To analyze the risk factors of concurrent urinary sepsis in patients with DM complicated with UUTCs by logistic regression.METHODS We retrospectively analyzed 384 patients with DM complicated with UUTCs treated in People’s Hospital of Jincheng between February 2018 and May 2022.The patients were screened according to the inclusion and exclusion criteria,and 204 patients were enrolled.The patients were assigned to an occurrence group(n=78)and a nonoccurrence group(n=126).Logistic regression was adopted to analyze the risk factors for urinary sepsis,and a risk prediction model was established.RESULTS Gender,age,history of lumbago and abdominal pain,operation time,urine leukocytes(U-LEU)and urine glucose(U-GLU)were independent risk factors for patients with concurrent urinary sepsis(P<0.05).Risk score=0.794×gender+0.941×age+0.901×history of lumbago and abdominal pain-1.071×operation time+1.972×U-LEU+1.541×U-GLU.The occurrence group had notably higher risk scores than the nonoccurrence group(P<0.0001).The area under the curve of risk score for forecasting concurrent urinary sepsis in patients was 0.801,with specificity of 73.07%,sensitivity of 79.36%and Youden index of 52.44%.CONCLUSION Sex,age,history of lumbar and abdominal pain,operation time,ULEU and UGLU are independent risk factors for urogenic sepsis in diabetic patients with UUTC.

基于Lasso-Logistic回归模型的胃癌影响因素分析

目的探究胃癌影响因素并构建临床预测模型。方法收集2020年12月~2023年10月就诊于上海中医药大学附属普陀医院及上海中医药大学附属曙光医院的1000例胃肿瘤患者的临床资料,经数据清洗剔除异常值后,分为胃息肉组(n=487)和胃癌组(n=479)。采用非参数检验筛选出有意义的指标,Lasso回归筛选具有非0系数的胃癌相关特征因素,逐步Logistic回归分析筛选出具有显著相关的因素,构建Lasso-Logistic回归模型,并绘制受试者工作特征(receiver operator characteristic,ROC)曲线计算曲线下面积(area under the curve,AUC)及混淆矩阵评估模型效能。结果多因素Logistic回归分析结果显示,年龄、白细胞计数(white blood cell,WBC)、单核细胞(monocyte,M)计数、谷丙转氨酶(alanine amiontransferase,ALT)、糖类抗原724(cancer antigen 724,CA724)、糖类抗原242(cancer antigen 242,CA242)、糖类抗原50(cancer antigen 50,CA50)、癌胚抗原(carcinoembryonic antigen,CEA)是胃癌的独立影响因素。基于多因素Logistic回归分析结果构建胃癌的风险预测列线图模型,测试集的AUC为0.91,精准率为100%,召回率为100%,验证集的AUC为0.93,精准率为93.63%,召回率为74.1%,模型预测效果良好。结论本研究构建8个胃癌常见预测因子,且Lasso-Logistic回归预测模型具有较好区分度,临床可基于患者体检报告,完成胃癌早期筛查。

基于logistic回归分析下颌第三磨牙近中、垂直阻生的危险因素

目的:探讨下颌第三磨牙近中、垂直阻生的危险因素,并基于logistic回归分析构建预测模型。方法:收集2021年6月—2023年12月天津市口腔医院243颗下颌第三磨牙的临床资料,根据萌出类型分为萌出组和阻生组,阻生组包括近中阻生和垂直单侧阻生。单因素分析筛选出具有统计学意义的因素后,采用logistic回归分析方法进行多因素分析,进一步绘制列线图,预测下颌第三磨牙阻生的风险因素。采用SPSS 27.0软件包对数据进行统计学分析。结果:243颗下颌第三磨牙中,萌出组75例(30.86%),阻生组168例(69.14%)。2组年龄、性别、牙根数、Co-Go、Co-Cop、W2、W3、W4和L相比,差异无统计学意义(P>0.05)。萌出组与阻生组Nolla、L-6缺失、L-E缺失、Co-Pog、Co-Go/Co-Pog、L6-MP、α和W1相比,差异有统计学意义(P<0.05)。多因素回归分析显示,Nolla、L-6缺失、L-E缺失、Co-Pog、Co-Go/Co-Pog、L6-MP、α和W1是下颌第三磨牙发生近中、垂直阻生的独立危险因素(P<0.05)。列线图构建显示较高的预测准确性。受试者工作特征曲线(ROC)分析结果表明,独立危险因素联合预测下颌第三磨牙近中、垂直阻生的曲线下面积(AUC)为0.924,95%CI为0.887~0.960,灵敏度为86.9%,特异度为86.7%。结论:Nolla、L-6缺失、L-E缺失、Co-Pog、Co-Go/Co-Pog、L6-MP、α和W1是影响下颌第三磨牙近中、垂直阻生的主要危险因素,利用logistic回归分析和列线图可有效预测阻生风险,为临床治疗提供科学依据。

基于Logistic回归分析建立慢性化脓性中耳炎合并听力损失的预测模型

目的:基于Logistic回归分析构建慢性化脓性中耳炎合并听力损失的预测模型。方法:选取2019年1月~2021年12月池州市第二人民医院收治的慢性化脓性中耳炎患者作为研究对象,依据听力损失发生情况分为听力损失组(n=117)和非听力损失组(n=102),使用单因素和多因素logistic回归分析慢性化脓性中耳炎合并听力损失的危险因素,并据此建立Logistic回归预测模型。结果:单因素分析显示,两组患者临床分类、慢性鼻窦炎、鼓室积脓和耳鸣障碍指数(THI)评分差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,活动期、慢性鼻窦炎、鼓室积脓和THI评分高是慢性化脓性中耳炎合并听力损失的独立危险因素(P<0.05)。模型验证结果显示,C-index为0.782(95%CI:0.748~0.816),校准曲线趋近于理想曲线,ROC曲线下面积(AUC)为0.774(95%CI:0.743~0.805),在0%~66%内,模型净获益值>0。结论:活动期、慢性鼻窦炎、鼓室积脓和THI评分高会增加慢性化脓性中耳炎合并听力损失的风险,根据危险因素构建的Logistic回归模型能有效预测慢性化脓性中耳炎合并听力损失的风险。

基于Logistic回归和Nomogram模型构建对非小细胞肺癌术后转移的预测价值

目的:探讨非小细胞肺癌术后转移的危险因素,并构建非小细胞肺癌术后转移的列线图模型。方法:选取2018年5月~2021年2月在南京市胸科医院进行手术治疗的265例非小细胞肺癌患者作为模型组,将2021年3月~2022年6月在我院进行手术治疗的96例非小细胞肺癌患者作为验证组。应用Lasso分析筛选非小细胞肺癌术后转移的预测因素,应用Logistic回归分析筛选非小细胞肺癌术后转移的危险因素,应用R(4.2.0)软件构建非小细胞肺癌术后转移的列线图模型,并对非小细胞肺癌术后转移的列线图模型进行验证。结果:Logistic回归分析结果显示,肿瘤最大径>3cm、分化程度、临床分期、癌胚抗原(CEA)、D-二聚体及MGMT基因启动子甲基化等是非小细胞肺癌术后转移的危险因素(P<0.05)。校正曲线显示模型组和验证组的预测值和实际值的拟合度皆较好;模型组和验证组的AUC分别为0.732和0.843。模型组的决策曲线显示非小细胞肺癌术后转移列线图模型的临床效用较好。结论:肿瘤最大径、分化程度、临床分期、CEA、D-二聚体及MGMT基因启动子甲基化等是非小细胞肺癌术后转移的影响因素,非小细胞肺癌术后转移的列线图模型有利于临床对非小细胞肺癌术后转移进行防治。

帕金森病脑深部电刺激术后并发症发生的Logistic回归分析

目的基于Logistic回归分析帕金森病(PD)脑深部电刺激术(DBS)后并发症发生的相关因素。方法纳入2019-12—2023-02张家口市第一医院收治的PD患者347例,均接受DBS治疗,术后随访30 d,以并发症发生情况为依据分为并发症组(n=31)和无并发症组(n=316),回顾性收集患者的临床资料。通过单因素及多因素Logistic回归分析PD患者DBS后发生并发症的相关因素。结果347例PD患者DBS后发生并发症31例,发生率8.93%。多因素Logistic分析显示,低蛋白血症、统一PD评定量表(UPDRSⅢ)评分升高、手术时间延长为PD患者DBS后并发症的相关因素(分别为OR=2.065,95%CI:1.167~3.652;OR=1.925,95%CI:1.278~2.899;OR=2.425,95%CI:1.323~4.444,P<0.05)。结论PD患者DBS后发生并发症的相关因素包括低蛋白血症、UPDRSⅢ评分升高、手术时间延长,可为筛选高危患者、制定临床防治策略提供依据。

基于Logistic回归的老年髋部骨折患者术后尿道感染风险预测模型构建与应用

目的探讨老年髋部骨折患者术后尿道感染风险因素,并以此构建老年髋部骨折术后患者尿道感染风险预测模型,并应用于老年髋部骨折围手术期。方法选取我院骨科2019年1月至2023年5月收治的老年髋部骨折患者1012例作为研究对象,其中发生术后尿道感染者111例。通过单因素分析初步筛选出老年骨科患者尿道感染的危险因素,综合考虑临床经验,将相关危险因素纳入多因素Logistic回归分析,并根据结果建立Logistic模型。结果纳入单因素、多因素Logistic回归分析模型分析,经筛选后发现,影响术后尿道感染的独立危险因素有低蛋白血症、电解质失衡、肺炎、糖尿病4项(P<0.05)。检测发现,预测模型在老年髋部骨折患者诊断中的敏感度、特异度各为83.78%,90.77%。结论低蛋白血症、电解质失衡、肺炎、糖尿病均是影响老年髋部骨折患者术后尿道感染风险的因素。基于本文列线图模型构建的老年髋部骨折尿道感染预测模型有良好的预测能力与准确性。

血液病患者PICC置管术后相关性静脉血栓影响因素的Logistic回归分析

目的 经外周置入中心静脉导管是维持血液病患者静脉治疗的首选方法,本研究主要探究血液病患者在PICC置管后导管相关性静脉血栓(PICC-RVT)的发生率及其影响因素。方法 通过回顾性分析2018年01月至2022年12月在中国医学科学院血液病医院(中国医学科学院血液学研究所)置入PICC导管的4 345例患者,收集其一般资料、实验室指标、相关置管信息及用药情况。采用1∶5倾向性评分匹配(PSM)平衡血栓与非血栓组之间的基线特征,采用二元Logistic回归分析探究血液病患者PICC置管术后发生PICC-RVT的影响因素,根据受试者工作特征(ROC)曲线分析对多因素结果进行验证。结果 4 345例血液病患者中有63人发生PICC-RVT,血栓发生率为1.45%。经PSM平衡后得到血栓组63例,非血栓组388例共451例。二元Logistic回归分析显示,影响血液病患者发生PICC-RVT的因素是诊断(OR=0.429,P<0.001)、体质指数(BMI)(OR=0.504,P<0.05)、白细胞计数(OR=0.443,P<0.001)、血小板计数(OR=1.902,P<0.05)、D-二聚体水平(OR=1.135,P<0.05)、是否输入血制品(OR=3.348,P<0.001)。ROC曲线下面积(AUC)为0.847,灵敏度0.794、特异性0.753,用于判断PICC-RVT有显著意义(P<0.001)。结论 本研究结果显示诊断、BMI、WBC、PLT、D-二聚体水平和输入血制品会增加血液病患者PICC-RVT的发生几率,是其影响因素。