老年吞咽障碍影响因素探究及其预测研究

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【中图分类号】R473.78

【文献标志码】A

【收稿日期】2024-11-04

Influencing factors for dysphagia in the elderly and establishment of a predictive model

PengPeng'，Chen Xinrui²，Zhou Yilin'，Tian Xiaoqin'，Tang Yuqin'，DengDan'

（1.DepartmentofHealth Statistics，ColegeofPublic Health，Chongqing Medical University;2.Chongqing Jiangbei District CenterforDiseaseControland Prevention/ChongqingJiangbei District Public Health InspectionOfice）

【AbstractObjective：Toinvestigatetheinfluencingactorsfordysphagiainteelderly，toconstructapredictiveodelfordsphgia，andtoprovideatoreticalbasisforclicalprctie.Methds：IisasecotrolstuyteatientswithspagiaoedDepartmentofGeriatricsintefistaffliatedhospitalofChongqingMedicalUniversityfromMarch2O16toJune2O23wereenroledscasegroup，andthepatients withoutdysphagiahoatendedthesamedepartmentduringthesameperiodof tmewereenroledascontrolgroup.Thoelatonalyss，astabsoluteshkageandelectiooperator（ASO）regressionndultivarateloisticgresionanalysiswereusedtoinvestigatetheinfluencingfactorsfordysphagia;thO-foldcrossvalidationExtremeGradientBosting（XGBoost）modelwasusedtopredictdysphagia，andthe SHapleyadditiveexPlanations（SHAP）methodwasusedfor modelvisualization.Results： There were 1OO9 cases in the case group and 2125 cases in the control group. The correlation analysis and LASSO regression analysis identified 12 factors for the multivariatelogistic regression analysis，and the results showed that sarcopenia，increasing age，children or caretakers as caregivers，frail health，poor oral health，poor self-care ability，depression，and cognitive impairment were risk factors for dysphagia（odds ratio[OR]>1， P <0.05），and femalesexandparticipationin communityactivitieswere protective factorsagainst dysphagia（ O R<1 ， P<0 . 0 5 ） .The XGBoost model had a good predictive efcacy，with an accuracy rate of O.795，a precisionrateofO.711，sensitivityof0.613，aspecificityofO.881，anF1valueof0.661，andanareaundertheROCcurveof0.855.The SHAPplotsowedtattetopfivemportantcharacteristiserecaregieralsore，frailhealthonditiontivitisofailyling， andcognitivefunctionConclusion：Therearevarious influencingfactorsfordysphagiaintheelderly，ndtheelderlypatientswith poororalhalth，frailtyependenceonthersfodailylifendogitiveimpamentsouldbeakeneriouslyinclinicalpactice. TheXGBoostmodelhasagodperformanceinpredictingdysphagiaintheelderlywhichcanprovideareferenceforclinicalpractice.

【Key words]dysphagia ; influencing factors ;predictive model; XGBoost model

近年来，随着老龄化进程的不断加快，老年群体的规模亦逐步扩大，但老年人群的生活质量和健康预期寿命受多种慢性疾病和退行性疾病的影响，其中吞咽障碍是一种常见老年综合征，在老年人群中的患病率为 。（剩余18528字）