基于决策树法构建心脏瓣膜置换术后病人低心排血量综合征发生风险的预测模型
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Construction of a predictive model for the risk of low cardiac output syndrome after heart valve replacement based on the decision tree method WANG Ziwei，CHEN Si
WuhanAsiaHeartHospital，Hubei43ooooChina
Corresponding Author WANG Ziwei，E-mail： wj15072352627@163.com
AbstractObjective：Toconstructapredictive modelfortheriskoflowcardiacoutputsyndrome（LCOS）afterheartvalvereplacement （HVR）basedonthe decision treemethod.Methods：Atotalof26Opatients whounderwent HVRsurgery inour hospital from June1， 2023 to June 3O，2O25 were selected as the study subjects and divided into a control group （n=213 ）and an LCOS group n=47 ）according tothepostoperativeLCOSoccurrence.Logisticregressonanalysis wasused toanalyzethe influencingfactorsofCOSafterHVR surgery，adecisionskpredictionodelastablisdndareauderteceiverperatingharacteristc（OC）cureseplo toevaluateitspredictiveeficacy.Results：Atotalof47of the26OpatientswhounderwentHVRsurgerydevelopedLCOS postoperatively，with an incidence rate of 18.08% .Logistic regression analysis showed that age，body mass index（BMI），electrolyte imbalance，intraoperative blood loss 3% ，cardiopulmonary bypass（CPB） time，and aortic cross-clamp（ACC） time were risk factors for LCOSafterHVR surgery P<0.05） 0.A decision tree model constructed based on these risk factors consisted of3 layers，15 nodes，and 8 terminalnodes，withintraoperativebloodlosasthefirstlayer，indicatingthatintraoperativebloodlossasthemostiortant influencingfactor.ROCcurveresultsshowedthattheAUCofthedecisiontreemodel（O.9Ol）washigherthanthatoftheLogistic regression model（O.852），and the difference was statistically significant Z=2.019 P=0.043 ）.Conclusions：The occurrence of LCOS afterHVRsurgeryisinfluencedbymultiplefactors.Therisk predictionmodelforLCOSafterHVRsurgeryconstructedbasedon influencing factors hasgood predictiveeficacywhichcanprovideabasis forclinicians toidentifyhigh-riskpatients early.
Keywordseartvalveelacementsurgery;lowcardiacutputsdrome;decisiotre;Logisticegresion;predictiveefcacy;usig
心脏瓣膜病属于心脏外科常见病之一，是由先天性发育异常或风湿等多种病因导致心脏瓣膜狭窄或/和关闭不全而引起的心脏疾病[1-2]。（剩余7171字）