采用决策树和logistic回归模型分析全髋关节置换术后手术部位感染的影响因素

周佩敏; 苏忠良; 徐青; 郑舒

doi:10.3969/j.issn.1006-5253.2019.06.002

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中国医院统计 ›› 2019, Vol. 26 ›› Issue (6) : 404-407. DOI: 10.3969/j.issn.1006-5253.2019.06.002

医院统计方法与应用

采用决策树和logistic回归模型分析全髋关节置换术后手术部位感染的影响因素

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Influencing factors of surgical site infection after total hip arthroplasty using decision tree and logistic regression model

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摘要

目的采用决策树与logistic回归模型分析髋关节置换术后手术部位感染发生的影响因素，为制订手术部位感染控制策略提供依据。方法回顾性收集2012年1月至2018年12月在温州市人民医院行全髋关节置换术患者的临床资料，以全髋关节置换术后发生手术部位感染的28例患者为病例组，以相同时间段内收治的未发生髋关节置换术后手术部位感染的576例患者为对照组，采用logistic回归和决策树模型分析手术部位感染发生相关影响因素。结果 logistic回归模型和决策树模型均筛选出4个危险因素，即手术时间≥180 min、术中出血量≥200 mL、抗生素使用种类≥2种以及术前血清白蛋白<35 g/L。决策树CHAID法分析结果显示，手术时间是影响手术部位感染发生最主要的因素。结论 CHAID决策树模型与logistic回归可互为补充，从各个方面描述影响手术部位感染发生的因素及作用，为进一步制定预防与控制手术部位感染的措施提供依据和参考。

Abstract

Objective To investigate risk factors for surgical site infection after total hip arthroplasty based on exhaustive CHAID decision tree and logistic regression model, so as to provide the basis for the development of control strategy of surgical site infection (SSI). Methods A retrospective analysis was performed on the patients undergoing total hip arthroplasty from January 2012 to December 2018 in Wenzhou People's Hospital. Twenty four patients with surgical site infection after total hip arthroplasty were selected as the case group, and 576 patients who did not have surgical site infection after total hip arthroplasty in the same period were selected as the control group. Logistic regression and decision tree model were used to determine influencing factors for surgical site infection. Results Four risk factors were found by logistic regression model and decision tree model, including the operation time no less than 180 min, the amount of intraoperative bleeding more than 200 mL, using at least 2 kinds of antibiotics, and serum albumin less than 35 `g/L. The results of CHAID decision tree analysis showed that the operation time was the main factor affecting the SSI. Conclusion In order to provide evidence and reference for prevention and control measure of surgical site infection, it is essential to combine these two different methods to describe influencing factors of surgical site infection from different aspects.

导出引用

周佩敏, 苏忠良, 徐青, 等. 采用决策树和logistic回归模型分析全髋关节置换术后手术部位感染的影响因素[J]. 中国医院统计, 2019, 26(6): 404-407 https://doi.org/10.3969/j.issn.1006-5253.2019.06.002

Zhou Peimin, Su Zhongliang, Xu Qing, et al. Influencing factors of surgical site infection after total hip arthroplasty using decision tree and logistic regression model[J]. Chinese Journal of Hospital Statistics, 2019, 26(6): 404-407 https://doi.org/10.3969/j.issn.1006-5253.2019.06.002

参考文献

［1］SEAGRAVE KG，TROELSEN A，MALCHAU H，et al．Acetabular cup position and risk of dislocation in primary total hip arthroplasty［J］．Acta Orthop，2017，88(1)：10-17． 

［2］马涛静．群组管理模式在髋关节置换术围手术期深静脉血栓预防中的应用［J］．中国医院统计，2016，23(3)：189-191．

［3］WESTBERG M，FRIHAGEN F，BRUN OC，et al．Effectiveness of gentamicincontaining collagen sponges for prevention of surgical site infection after hip arthroplasty：A multicenter randomized trial［J］．Clin Infect Dis，2015，60(12)：1752-1759．

［4］MEROLLINI KM，CRAWFORD RW，WHITEHOUSE SL，et al．Surgical site infection prevention following total hip arthroplasty in Australia：A costeffectiveness analysis［J］．Am J Infect Control，2013，41(9)：803-809．

［5］BERROSTORRES SI，UMSCHEID CA，BRATZLER DW，et al．Centers for disease control and prevention guideline for the prevention of surgical site infection，2017［J］．JAMA Surg，2017，152(8)：784-791．

［6］陈橙,颜艳,何琼,等.决策树与logistic回归模型用于开奶时间延迟影响因素分析［J］.中南大学学报(医学版)，2018,43(3):306-312.

［7］医院感染诊断标准(试行)［J］．中华医学杂志，2001，81(5)：61-67.

［8］杜英勋，吴汝平，闫青，等．人工髋关节置换术后感染的危险因素与预防［J］．中华医院感染学杂志，2015，25(9)：2094-2096．

［9］黄郁竹，张冰琦，杨忠贤，等．髋关节置换术后医院感染的相关因素及护理管理策略［J］．国际护理学杂志，2016，35(22)：3141-3143．

［10］PAVEL A，SMITH RL，BALLARD A，et al．Prophylactic antibiotics in clean orthopaedic surgery［J］．J Bone Joint Surg Am，1974，56(4)：777-782．

［11］蔡红升．我国全髋关节置换术后手术部位感染危险因素的Meta分析［D］．遵义：遵义医学院，2017．

［12］TRIANTAFYLLOPOULOS G，STUNDNER O，MEMTSOUDIS S，et al．Patient，surgery，and hospital related risk factors for surgical site infections following total hip arthroplasty［J］．Sci World J，2015：979560．

［13］RASOULI MR，RESTREPO C，MALTENFORT MG，et al．Risk factors for surgical site infection following total joint arthroplasty［J］．J Bone Jo SurgAm，2014，96(18)：e158．