随机森林算法预测单纯掌侧钢板内固定术后背侧关节内骨块稳定性及模型构建和验证  

Random Forest Algorithm for Predicting Stability of Dorsal Intra-articular Bone Mass After Simple Palmar Plate Internal Fixation and Model Construction and Validation

作　　者：赵东华 杜云峰 王红星 ZHAO Donghua;DU Yunfeng;WANG Hongxing(Department of Orthopedic Medicine,Henan Coal Industry(Group)Co.,Ltd.Central Hospital,Jiaozuo 454000,China)

机构地区：[1]河南煤业(集团)有限责任公司中央医院骨科,河南焦作454000

出　　处：《河南医学研究》2024年第22期4110-4115,共6页Henan Medical Research

摘　　要：目的基于随机森林算法分析桡骨远端骨折患者接受单纯掌侧钢板内固定术后背侧关节内骨块稳定性的影响因素,构建随机森林模型预测术后背侧关节内骨块稳定性风险。方法采用便利抽样法,选取2017年1月至2022年1月于河南煤业(集团)有限责任公司中央医院行单纯掌侧钢板内固定术治疗的320例桡骨远端骨折为研究对象,统计术后背侧关节内骨块稳定性,依据骨块是否移位分为稳定组、非稳定组。收集两组一般资料及骨折、手术相关诊治信息。单因素、多因素logistic回归分析术后背侧关节内骨块稳定性的影响因素。建立随机森林模型,并分析该模型对术后背侧关节内骨块稳定性的预测价值。结果术后12个月内背侧关节内骨块移位发生率为27.22%;C3型骨折、锁定加压钢板内固定、术前骨块总移位距离、骨块横向宽度、骨块横纵比、骨块体积是术后背侧关节内骨块稳定性的影响因素(P<0.05);重要性分析显示影响术后背侧关节内骨块稳定性变量的重要性由高到低的前4位依次为术前骨块总移位距离、锁定加压钢板内固定、骨块体积、骨块横向宽度;随机森林模型预测术后背侧关节内骨块稳定性风险的灵敏度为91.02%,特异度为82.36%。结论基于随机森林算法构建的预测模型对单纯掌侧钢板内固定术后背侧关节内骨块稳定性具有一定预测价值,有助于早期识别高危患者,对背侧钢板的选择具有指导价值。Objective To analyse the factors influencing the stability of the dorsal intra-articular bone mass in patients with distal radius fractures who underwent internal fixation with a simple palmar plate based on the random forest algorithm,and to construct a random forest model to predict the risk of stability of the dorsal intra-articular bone mass after surgery.Methods A convenient sampling method was used to select 320 cases of distal radius fracture treated with simple volar plate internal fixation in Henan Coal Industry(Group)Co.,Ltd.Central Hospital from January 2017 to January 2022 as the research objects.The stability of the bone mass in the dorsal joint after surgery was analyzed,and the patients were divided into stable group and unstable group according to whether the bone mass was displaced or not.General data,diagnosis and treatment information related to fracture and operation were collected from the two groups.Univariate and multivariate logistic regression analysis were used to analyze the factors affecting the stability of the bone mass in the dorsal joint after surgery.The stochastic forest model was established based on logistic regression analysis,and the predictive value of the model to the stability of the bone mass in the postoperative dorsal joint was analyzed.Results The incidence of bone mass displacement in dorsal joint was 27.22%within 12 months after operation.C3 fracture,locking compression plate internal fixation,total displacement distance of bone mass before surgery,transverse width of bone mass,transverse and longitudinal ratio of bone mass and bone mass volume were the influencing factors of postoperative stability of bone mass in the dorsal joint(P<0.05).Significance analysis showed that the top 4 variables affecting the stability of postoperative dorsal joint bone mass from high to low in importance were the total displacement distance of preoperative bone mass,internal fixation with locking compression plate,bone mass volume,and transverse width of bone mass.The sensitivity and s

关 键 词：桡骨远端骨折 掌侧内固定 关节内骨折 稳定性 随机森林算法 

分 类 号：R683[医药卫生—骨科学]