基于決策樹構(gòu)建脊柱術(shù)后病人發(fā)生尿潴留的早期預(yù)測模型

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Early prediction model of urinary retention in patients after spinal surgery based on decision tree

GENG Guimin， QIU Xiaoli， WANG Yan， LUO Shunmei， CHEN Jing， JIANG Rong， SHU Li

The First People's Hospital of Zunyi， Guizhou 563000 China

Corresponding Author  GENG Guimin， E?mail： 1371605550@qq.com

Abstract  Objective：To explore the establishment of early prediction decision tree model for urinary retention after catheter removal in patients undergoing spinal general anesthesia.Methods：The relevant factors，surgical factors and postoperative factors of 498 patients undergoing spinal surgery in the First People's Hospital of Zunyi from March 2017 to December 2021 were retrospectively collected.An early prediction model of urinary retention in patients with spinal general anesthesia after catheter removal was established based on decision tree.349 cases were randomly selected as a training set for model construction.The remaining 149 cases were used as a validation set to evaluate the effectiveness of the model.The prediction performance of the decision tree model was evaluated by calculating the AUC value of confusion moment.Results：Urinary retention occurred in 90 of 498 patients（18.07%） after catheter removal.The decision tree model showed that the time of bed rest，catheter clamping training，anesthesia time，indwelling catheter time，and catheter removal time were the influencing factors of urinary retention in patients with spinal general anesthesia after catheter removal.The area under the ROC curve of decision tree model in the training set and the validation set for predicting urinary retention after removal of urinary duct after spinal general anesthesia was 0.909（95%CI 0.865?0.953） and 0.914（95%CI 0.845?0.982），respectively；sensitivity was 83.3% and 81.8%，respectively；specificity was 87.9% and 89.0%，respectively.There was no statistical difference in ROC curve between the two groups（P>0.05）.Conclusion：The time of bed rest，catheter clamping training，anesthesia time，indwelling catheter time，and catheter removal time were the influencing factors of urinary retention in patients with spinal general anesthesia after catheter removal.The predictive model constructed in this study has good diagnostic sensitivity and specificity.

Keywords  spinal surgery； urinary retention； influencing factors； decision tree； prediction model； nursing

摘要  目的：構(gòu)建全身麻醉脊柱術(shù)后病人拔除尿管后發(fā)生尿潴留的早期預(yù)警決策樹模型。（剩余10935字）