老年吞咽障礙影響因素探究及其預(yù)測(cè)研究
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【中圖分類(lèi)號(hào)】R473.78
【文獻(xiàn)標(biāo)志碼】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
近年來(lái)，隨著老齡化進(jìn)程的不斷加快，老年群體的規(guī)模亦逐步擴(kuò)大，但老年人群的生活質(zhì)量和健康預(yù)期壽命受多種慢性疾病和退行性疾病的影響，其中吞咽障礙是一種常見(jiàn)老年綜合征，在老年人群中的患病率為 。（剩余18528字）