基于隨機(jī)森林模型的耐碳青霉烯類鮑曼不動(dòng)桿菌性呼吸機(jī)相關(guān)性肺炎風(fēng)險(xiǎn)預(yù)測模型的構(gòu)建

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Construction of a risk prediction model for ventilator?associated pneumonia caused by carbapenem resistant Acinetobacter baumannii based on random forest model

Abstract  Objective：To analyze the risk factors for ventilator?associated pneumonia caused by carbapenem?resistant Acinetobacter baumannii（CRAB）.Random forest model and Logistic regression two methods were used to construct prediction models，to provide theoretical basis for ICU to reduce the risk of CRAB ventilators associated pneumonia.Methods：A total of 291 patients with ventilators associated pneumonia admitted to ICU from January 2018 to December 2022 were selected as the study subjects.The influencing factors of CRAB ventilators associated pneumonia were analyzed.The predictive model was constructed based on random forest model and Logistic regression，and the operating characteristic curve（ROC） and area under the curve（AUC） were calculated to compare the differences between the two models.Results：Multivariate analysis results showed that oxygenation index，tracheotomy and coma were independent influencing factors of CRAB ventilator?associated pneumonia.The AUC of the random forest model was 0.78，and the AUC of the Logistic regression model was 0.61.The accuracy（77.97%），sensitivity（85.37%），and specificity（61.11%） of the random forest model were higher than those of the Logistic regression model（66.10%，73.17%，50.00%）.Conclusion：Oxygenation index，duration of antibiotic use，tracheotomy and coma are risk factors for CRAB ventilator?associated pneumonia.The random forest prediction model outperforms the Logistic regression model in predicting CRAB ventilator?associated pneumonia.

Keywords  carbapenem resistant Acinetobacter baumannii； ventilator?associated pneumonia， VAP； influencing factors； random forest； Logistic regression； prediction model

摘要  目的：分析耐碳青霉烯類鮑曼不動(dòng)桿菌（CRAB）性呼吸機(jī)相關(guān)性肺炎發(fā)生的風(fēng)險(xiǎn)因素，并采用隨機(jī)森林模型和Logistic回歸兩種方法構(gòu)建預(yù)測模型，為重癥監(jiān)護(hù)室降低CRAB性呼吸機(jī)相關(guān)性肺炎的發(fā)生風(fēng)險(xiǎn)提供理論依據(jù)。（剩余11292字）