基于随机森林模型的住院老年肌少症患者现况及影响因素分析

Current Situation and Influencing Factors Analysis of Hospitalized Elderly Patients with Sarcopenia Based on Random Forest Model

摘要: 目的：探讨住院老年患者肌少症现况并分析其影响因素，对早期肌少症患者识别提供依据。方法：2020年7月~2021年9月在新疆医科大学第一附属医院老年病科住院的老年患者采用便利抽样法抽样372例，采用一般资料、体格检查、实验室检查、量表评定，肌少症相关指标诊断对其进行调查。结果：住院老年患者肌少症患病率18.82%，男性23.84%、女性14.50%。随机森林算法结果进行重要性变量排序，LASSO回归分析当lambda.min值为0.00017时，误差最小，对应的影响因素数目为12个，重要性排序居前12位的自变量为SMI、性别、BMI、体重、年龄、身高、握力、腹围、步速、营养风险、日常生活能力评分、Alb。多因素logistics回归分析结果显示，性别、BMI、步速、握力、腹围是肌少症患者的影响因素(P < 0.05)。结论：年龄、性别、BMI、步速、握力、腹围与住院老年患者肌少症的发生相关，早期干预能减少肌少症的发生。

Abstract: Objective: To investigate the present situation of sarcopenia in hospitalized elderly patients and analyze its influencing factors, so as to provide evidence for the identification of early sarcopenia patients. Methods: From July 2020 to September 2021, 372 elderly patients hospitalized in the geriatrics Department of the First Affiliated Hospital of Xinjiang Medical University were sampled by convenience sampling method. General information, physical examination, laboratory examination, scale assessment and diagnosis of sarcopenia related indicators were used to investigate them. Results: The prevalence of sarcopenia in hospitalized elderly patients was 18.82%, 23.84% in males and 14.50% in females. Rank the importance variables in the results of random forest algorithm. In LASSO regression analysis, when lambda.min value is 0.00017, the error is the smallest, and the corresponding number of influencing factors is 12. The top 12 independent variables ranked in importance were SMI, sex, BMI, weight, age, height, grip strength, abdominal circumference, walking speed, nutritional risk, daily living ability score, and Alb. The results of multi-factor logistics regression analysis showed that gender, BMI, walking speed, grip strength and abdominal circumference were the influencing factors of patients with sarcopenia (P < 0.05). Conclusion: Age, sex, BMI, walking speed, grip strength and abdominal circumference are related to the occurrence of sarcopenia in hospitalized elderly patients. Early intervention can reduce the occurrence of sarcopenia.