十年MACE分类规则 初级保健中风险 塔拉哥纳老年人患有2型糖尿病:CHAID决策树分析
D Ribas Seguí1,2, MJosé Forcadell3,4, Angel Vila-Córcoles5,3
1Primary Health Care Service 'Camp de Tarragona', Institut Catala de La Salut, Tarragona, Spain. dribas.hj23.ics@gencat.cat.
BMC primary care
|April 25, 2025
概括
这项研究开发了一种简单的工具,用于预测60岁以上2型糖尿病 (T2DM) 患者的心血管风险. 在初级保健中,CHAID模型识别了主要心血管不良事件 (MACE) 的高风险个体.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 心血管疾病 (CVD) 是2型糖尿病患者死亡的主要原因.
- 在60岁以上的T2DM患者中预测心血管疾病风险对于初级保健干预至关重要.
- 现有的风险评估工具可能无法在初级保健机构优化T2DM群体.
研究的目的:
- 开发和验证一种简单的工具,用于预测60岁以上T2DM患者10年内发生重大心血管不良事件 (MACE) 的风险.
- 用决策树模型在初级保健环境中对T2DM患者的心血管风险进行分层.
- 在这个特定的患者队列中确定MACE的关键预测因子.
主要方法:
- 从2009年1月1日到2018年12月31日,对60岁以上的T2DM患者进行了回顾性队列研究.
- 主要结局:MACE (急性心肌梗塞,中风,心血管死亡) 通过ICD-9代码确定.
- 千平方自动交互探测器 (CHAID) 决策树分类用于风险预测.
主要成果:
- 该研究包括5554名T2DM患者;779人在10年内发展出MACE.
- CHAID模型将年龄确定为主要预测因素,创造了三个风险组.
- 确定了特定的风险因素:高血压和低HDL-c (<39 mg/dL) 在71岁以下的患者中 (19.9%的MACE风险);高禁食葡萄糖 (>177 mg/dL) 在71-75岁患者中 (27.2%的MACE风险).
结论:
- 基于CHAID的分类树为T2DM患者的心血管风险分层提供了有效的决策规则.
- 这种方法简化了风险评估,使其成为初级保健的宝贵工具.
- 开发的工具有助于识别高风险T2DM患者,以有针对性的心血管风险管理.
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