基于随机森林算法构建StanfordA型主动脉夹层术后谵妄的预测模型
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doi：10.12102/j.issn.1672-1349.2025.14.015
ThePredctionModelforPostoperativeDeliriuminStanfordTypeAAorticDissection BasedonRandomForestAlgortm LIU Chunyan，LI Jingjing，WU Guiqin，ZHANG Pingzhen，LI Songjun，ZHOU Jinling
Corresponding Author WU Guiqin，E-mail：1371115728@ qq.com
AbstractObjectiveToanaletheisfactorsofpotoperativedeliiumipatientswithStafordtypeAaorticdiectioadtoetablish arandomforestmodelMethods：Atotalof185patientswithStanfordtypeAaortcdissectioninourhospitalfromJanuary016toOctober 2023weredividedintothedeliumgroupandthenon-deliumgroupaccordingtowhetherdeliriumocuredaftertheoperation.The linicadatasflptintsreoltedirategistiegessosusedtoeentisfacsofptoperativriumA randomforestmodelforpredictingpostoperativedeliuinStanfordtypeAaorticdisectionwasestablisedusingRsoftareesults： Among185patientswithStanfordtypeAaorticdissectionpostoperaivedeliiumocurredin33patientswitStanfordtypeAaortic dissectionilstoatielidisitafdtortietioideefi delirium was 17.84%（33/185） .Therewerestatisticaly significantdiferences inhypoxemia，D-dimer，blood lactate，operation time，deep hypothermiccirculatoryarest timeandmechanical ventiationtime betweenthedlirum groupandthenon-deliumgroup ⌈P<0.05⌉ Hypoxemia，D-dimer> 15.46mg/L ，bloodlactate >2.87mmol/L ，operationtime > 265.81min，deephypothermiacirculatoryarrest time > 44.32min ，andmechanical ventilation time >64.83 hwere independent risk factors for postoperative delirium inpatients with type Aaortic dissection（ P<0.05） .Therankingof relatively important predictors forpredictingpostoperative delirum wereoperationtime，mechanical ventilationtipotaiulatoesttilodlactateDidoeieagductioible Ginivaluewasproportionaltoitsimportanceinthemodel.TheareaunderthereceiveroperatingcharacteriticsROC）curveof the randomforestalgorithmforpredicting postoperativedlirium was higher thanthatofthemutivariate Logisticregression model （Z=2.296， P=0.022 ）.Conclusion：Hypoxemia，D-dimer>15.46mg/L，blood lactate 2.87mmol/L ，operation time>265.81 min，deep hypothermiacirculatoryarresttime >44.32 min，and mechanical ventilation time >64.83 hwere the influencing factors for postoperative deliriumipatientswithStanfordtypeAaorticdissection.Therandomforestmodelwasconstructedbasedontheabovefactorswith better risk prediction efficiency.
KeywordsStanfordtypeAaortic dissection;postoperativedelirium;influencing factors;random forestmodel
主动脉夹层是一种严重威胁生命健康的危重症心血管疾病[1]。（剩余8014字）