急性心肌梗死患者就医延迟风险预测模型的构建与验证  

Construction and validation of a risk prediction model for delayed medical treatment in patients with acute myocardial infarction

作　　者：徐袁凤 张诚霖 李学美[2] 李晓燕[1] 陈雾 XU Yuanfeng;ZHANG Chenglin;LI Xuemei;LI Xiaoyan;CHEN Wu(Department of Cardiology,Yancheng Third People’s Hospital,Yancheng 224001,Jiangsu,China;Department of Nursing,Yancheng Third People’s Hospital,Yancheng 224001,Jiangsu,China)

机构地区：[1]盐城市第三人民医院心内科,江苏盐城224001 [2]盐城市第三人民医院护理部,江苏盐城224001

出　　处：《中国现代医生》2025年第10期16-19,33,共5页China Modern Doctor

基　　金：江苏医药职业学院2023年度校地协同创新研究项目(20239127)。

摘　　要：目的构建急性心肌梗死(acute myocardial infarction,AMI)患者就医延迟的风险预测模型,并评估该模型的预测效能。方法采用便利抽样法,选取2023年3月至2024年5月于盐城市第三人民医院住院的219例AMI患者为调查对象,以6h为界,将AMI患者分为就医延迟组(n=106)和就医未延迟组(n=113)。采用Logistic回归分析建立AMI患者就医延迟风险预测模型,应用Hosmer-Lemeshow检验和受试者操作特征曲线评价模型的拟合优度及预测能力。结果二元Logistic回归分析结果显示年龄、发病时不知晓是心脏病、首次胸痛、健康素养简要筛查问卷评分低均是AMI患者就医延迟的危险因素(P<0.05)。该模型预测AMI患者就医延迟的曲线下面积为0.771,约登指数为0.562,最佳临界值为0.514,敏感度和特异性分别为77.3%和86.5%。结论构建的风险预测模型能有效预测和筛查AMI就医延迟高危人群,降低AMI患者的就医延迟风险,并为采取合理的干预措施缩短AMI患者就医时间提供科学依据。Objective To construct a risk prediction model for delayed medical treatment in patients with acute myocardial infarction(AMI),and to evaluate the predictive performance of the model.Methods Convenience sampling method was used to select 219 patients with AMI who were hospitalized in Yancheng Third People’s Hospital from March 2023 to May 2024 as investigation objects.The patients with AMI were divided into delayed group(n=106)and undelayed group(n=113)with the 6-hour interval.Logistic regression analysis was used to establish a risk prediction model for AMI patients with delayed medical treatment.Hosmer-Lemeshow test and receiver operating characteristic curve were used to evaluate the goodness of fit and prediction ability of the model.Results Binary Logistic regression analysis showed that age,unknown heart disease at the time of onset,first chest pain and low score of brief health literacy screen were all risk factors for delayed medical treatment in AMI patients(P<0.05).The model predicted that the area under the curve of AMI patients with delayed hospitalization was 0.771,the Youden index was 0.562,the optimal cutoff value was 0.514,and the sensitivity and specificity were 77.3%and 86.5%,respectively.Conclusion The constructed risk prediction model can effectively predict and screen the high-risk groups of AMI patients with delayed medical treatment,reduce the risk of AMI patients with delayed medical treatment,and provide a scientific basis for taking reasonable intervention measures to shorten the time of medical treatment for AMI patients.

关 键 词：急性心肌梗死 就医延迟 预测模型 

分 类 号：R541.4[医药卫生—心血管疾病]