基于加权TOPSIS法的老年人房颤风险评价研究  

Risk assessment of elderly patients with atrial fibrillation based on weighted TOPSIS method

作　　者：王晓晗 王培承[1] 安洪庆[1] WANG Xiao-han;WANG Pei-cheng;AN Hong-qing(School of Public Health,Weifang Medical University,Weifang,Shandong 261053,China)

机构地区：[1]潍坊医学院公共卫生学院,山东潍坊261053

出　　处：《现代预防医学》2022年第23期4394-4399,4411,共7页Modern Preventive Medicine

基　　金：中国学位与研究生教育学会课题(2020MSA105);山东省教育科学“十三五”规划课题(2020ZC237);山东省高等医学教育研究中心规划课题(YJKT202126)。

摘　　要：目的利用国家基本公共卫生服务项目健康体检指标,构建简易房颤风险评价体系,对60岁及以上老年居民房颤风险进行评价,为房颤高风险人群健康管理和干预工作提供科学依据。方法运用德尔菲法确定指标体系,根据层次分析法得到权重值。结合老年人健康体检数据,采用TOPSIS综合评价法进行分析,从而获得老年人房颤风险评估价值。对评价值进行K-均值聚类分析,以确定房颤风险的等级及界值。结果本研究采用分层随机整群抽样方法进行抽样,抽取9个县市区27个社区5759名60岁以上老年居民。经数据删失、填充和清洗后共纳入60岁及以上老年居民5534人。基于层次分析法、TOPSIS法和K-均值聚类的老年居民房颤风险评价体系可以将居民房颤风险分为3档。其中,低风险居民占7.0%,中风险居民占58.3%,高风险居民占34.7%。结论潍坊市老年居民房颤风险评价显示,房颤的评价值大多处于中风险区间内,高风险次之,处于低风险区间的样本数量最少。对不同风险区间内老年居民采取针对性干预控制措施,警惕房颤风险由低、中风险区间向中、高风险区间发展。Objective To evaluate the risk of atrial fibrillation in elderly residents aged 60 and above by using the physical examination indicators of national basic public health service project and establishing a simple atrial fibrillation risk assessment system,and to provide scientific basis for health management and intervention of high-risk population of atrial fibrillation.Methods The index system was determined by Delphi method and the weight value was obtained by analytic hierarchy process.Combined with the health physical examination data of the elderly,TOPSIS comprehensive evaluation method was used for analysis,so as to obtain the risk evaluation value of atrial fibrillation in the elderly.K-means clustering analysis was performed to determine the grade and threshold of atrial fibrillation risk.Results In this study,5759 elderly residents over 60 years old were selected from 27 communities in 9 counties and urban districts by stratified random cluster sampling.A total of 5534 elderly residents aged 60 and above were included after data deletion,filling and cleaning.The risk assessment system of atrial fibrillation for elderly residents based on analytic hierarchy process(AHP),TOPSIS and K-means clustering could divide the risk of atrial fibrillation into 3 levels.Among them,low-risk residents accounted for 7.0%,medium-risk residents accounted for 58.3%,and high-risk residents accounted for 34.7%.Conclusion The risk assessment of atrial fibrillation in elderly residents in Weifang City shows that most of the assessed values of atrial fibrillation are in the middle-risk range,followed by the high-risk range,and the number of samples in the low-risk range is the least.Targeted intervention and control measures should be taken for elderly residents in different risk ranges to guard against the development of atrial fibrillation risk from low and medium-risk ranges to medium and high-risk ranges.

关 键 词：房颤 风险评估 德尔菲法 层次分析法 TOPSIS法 K-均值聚类 

分 类 号：R541.75[医药卫生—心血管疾病]