老年多重慢性病与饮食习惯的关系及风险预测模型构建  

Relationship between eating habits and multiple chronic diseases in the elderly and construction of risk prediction model

作　　者：陈凤 苏恩惠 郭丹丹 吕阳阳 韩世范 朱瑞芳[4,5] CHEN Feng;SU Enhui;GUO Dandan;LYU Yangyang;HAN Shifan;ZHU Ruifang(Shanxi Bethune Hospital(Tongji Shanxi Hospital,Shanxi Academy of Medical Sciences),Third Hospital of Shanxi Medical University,Shanxi 030032 China)

机构地区：[1]山西白求恩医院(山西医学科学院同济山西医院)山西医科大学第三医院,山西030032 [2]山西医科大学 [3]山西中医药大学 [4]山西医科大学第一医院 [5]山西医科大学循证护理研究中心

出　　处：《护理研究》2024年第15期2683-2689,共7页Chinese Nursing Research

基　　金：2023—2024年度山西省大健康产业高质量发展科研专项课题,编号:DJKZXKT2023157,DJKZXKT2023002。

摘　　要：目的:探讨饮食习惯与老年多重慢性病的关系及风险因素,并依据风险因素构建预测模型。方法:选取2020年1月—2023年12月我院收治的484例老年慢性病病人作为建模组,其中多重慢性病病人363例(病例组),单一慢性病病人121例(对照组),另选取同期收治的161例老年慢性病病人作为验证组。收集病人的一般资料及饮食习惯,采用多因素Logistic回归分析探讨饮食习惯与老年多重慢性病的关系并筛选影响因素,根据筛选出的影响因素构建列线图风险模型,并对该模型进行预测效果评价。结果:过快饮食、过饱饮食、每周食用油炸及腌制食品≥4 d、年龄>80岁、体质指数>24.0 kg/m^(2)、有家族病史是老年多重慢性病的影响因素(P<0.05),每周食用新鲜蔬菜水果≥4 d、每周食用鱼肉≥4 d是老年多重慢性病的保护因素(P<0.05)。基于以上影响因素构建风险列线图模型,Bootstrap自举法内部验证结果显示,受试者工作特征(ROC)曲线下面积为0.873[95%CI(0.810,0.941)],校准曲线显示实际值与预测值间的平均绝对误差为0.025;验证组内部验证结果显示,ROC曲线下面积为0.912[95%CI(0.823,0.986)],校准曲线分析显示实际值与预测值间的平均绝对误差为0.022。结论:过快饮食、过饱饮食、每周食用油炸及腌制食品≥4 d、年龄>80岁、体质指数>24.0 kg/m^(2)、有家族病史是老年多重慢性病的影响因素,基于此建立的列线图模型有助于该类病人的健康管理。Objective:To explore the relationship between eating habits and multiple chronic diseases in the elderly and the risk factors,and to build a prediction model according to the risk factors.Methods:484 elderly patients with chronic diseases admitted to our hospital from January 2020 to December 2023 were selected as the modeling group,including 363 patients with multiple chronic diseases(case group)and 121 patients with single chronic disease(control group).Another 161 elderly patients with chronic diseases were selected as verification group.Obtain general information and eating habits of patients.The relationship between eating habits and multiple chronic diseases in the elderly was discussed by multivariate Logistic regression analysis,and the influencing factors were screened.According to the screened influencing factors,a Nomograph risk model was constructed,and the predictive effectiveness of the model was evaluated.Results:Eating too fast,eating too full,eating fried and pickled foods≥4 d per week,being over 80 years old,having BMI>24.0 kg/m^(2) and having a family history were the influencing factors of multiple chronic diseases in the elderly(P<0.05),while consumption of fresh vegetables and fruits≥4 d per week and consumption of fish≥4 d per week were protective factors(P<0.05).Based on the above influencing factors,the risk nomogram model was constructed.The internal verification results showed that the area under ROC curve was 0.873(95%CI 0.810-0.941),and the average absolute error between the actual value and the predicted value showed by the calibration curve was 0.025;The internal verification results show that the area under ROC curve was 0.912(95%CI 0.823-0.986),and the analysis of calibration curve showed that the average absolute error between the actual value and the predicted value was 0.022.Conclusion:Eating too fast,eating too full,eating fried and pickled food for≥4 d per week,being over 80 years old,having BMI>24.0 kg/m^(2) and having a family history are the influencing factors of

关 键 词：老年人 多重慢性病 饮食习惯 影响因素 列线图模型 

分 类 号：R473[医药卫生—护理学]