基于BP神经网络的开颅术后患者病情恶化风险预测模型构建及验证  

The development and validation of BP neural network-based risk prediction model for deterioration in patients after craniotomy

作　　者：许来雨 彭伶丽[4] 徐慧兰 唐云红[2] 周芳意[1] 曹浪平[2] XU Laiyu;PENG Lingli;XU Huilan;TANG Yunhong;ZHOU Fangyi;CAO Langping(Teaching and Research Section of Clinical Nursing,Xiangya hospital of Central South University,Changsha,410008,China)

机构地区：[1]中南大学湘雅医院临床护理学教研室,长沙市410008 [2]中南大学湘雅医院神经外科,长沙市410008 [3]中南大学湘雅公共卫生学院 [4]国家老年疾病临床医学研究中心(湘雅医院)

出　　处：《中国护理管理》2022年第12期1787-1792,共6页Chinese Nursing Management

基　　金：湖南省自然科学基金项目(2021JJ31042);湖南省卫生健康委科研计划项目(202114052096)。

摘　　要：目的:分析开颅术后患者发生病情恶化的预测变量,并构建开颅术后患者病情恶化风险预测模型。方法:选取湖南省3家三级甲等综合医院2018年1月至2020年3月的开颅手术患者1576例为研究对象,将样本按照7∶3的比例随机分为建模组(n=1106)和验证组(n=470),采用BP神经网络构建预测模型,并检验模型的预测效果。结果:BP神经网络变量重要性评分中,术后24 h内CT示颅内血肿、SpO2等指标对模型分类的贡献度较高。预测模型的灵敏度为77.1%,特异度为91.7%,正确率为86.8%,阳性预测值为82.3%,阴性预测值为88.9%。结论:基于BP神经网络构建的预测模型具有良好的预测效能,为临床医护人员预测开颅术后患者病情恶化风险提供了科学、客观的参考依据。Objective:To explore the predictors of deterioration in patients after craniotomy and to construct a risk prediction model.Methods:A total of 1,576 eligible patients were selected at three tertiary grade A hospitals in Hunan province from January 2018 to March 2020.The research samples were randomly divided into the training set(n=1,106)and the verification set(n=470)according to the ratio of 7:3,and the BP neural network was used to construct the prediction model.The predictive effect of the model was verified.Results:In the BP neural network variable importance score,intracranial hematoma on CT within 24 h after craniotomy and SpO2contributed more to the model classification.The sensitivity of the prediction model was 77.1%,the specificity was 91.7%,the accuracy was 86.8%,the positive predictive value was 82.3%,and the negative predictive value was 88.9%.Conclusion:The prediction model based on the BP neural network algorithm has good predictive effects,which might provide a scientific and objective reference for clinical staff to predict the risk of patients’deterioration after craniotomy.

关 键 词：开颅术 病情恶化 风险预测 神经外科 BP神经网络 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]