Identification of influencing factors for falls in hospitalized patients with cardiovascular diseases and construction of a prediction model based on machine learning technology
10.3760/cma.j.cn211501-20250227-00544
- VernacularTitle:基于机器学习技术的心血管病住院患者跌倒影响因素识别及预测模型构建
- Author:
Jing TAO
1
;
Lei TAO
;
Xiaoxuan GONG
;
Bingsen HUANG
;
Yueting LIU
;
Min ZHANG
;
Yujiao MA
;
Keyu CHEN
Author Information
1. 南京医科大学第一附属医院心血管内科，南京 210029
- Publication Type:Journal Article
- Keywords:
Cardiovascular diseases;
Accidental falls;
Risk factors;
Hospitalized patients;
Machine learning
- From:
Chinese Journal of Practical Nursing
2025;41(33):2607-2612
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the fall risk of hospitalized patients with cardiovascular diseases, analyze the related influencing factors, and construct a prediction model based on machine learning technology, so as to provide a basis for the fall management of hospitalized patients with cardiovascular diseases.Methods:This study was a retrospective cohort study. A total of 450 patients admitted to the Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University from June 2017 to June 2024 were selected as the research objects by convenience sampling method. By reviewing electronic medical records, trained nurses extracted the patients' general information and Activities of Daily Living Scale (ADL) scores during hospitalization. Lasso regression was used to screen risk factors, and machine learning libraries were used to construct support vector machine (SVM), decision tree, XGBoost, and neural network models. Bootstrap resampling method and area under the curve (AUC) were used to verify the model performance.Results:Among the 450 patients, there were 261 males and 189 females, with a mean age of (66.0 ± 8.4) years. Among them, 90 patients fell during hospitalization and 360 patients did not fall. The results of Lasso regression showed that ADL score ≤60 points, use of hypnotics, hypokalemia, nighttime toilet visits≥2 times, use of antihypertensive drugs, no caregiver, and history of atrial fibrillation were all risk factors for falls in hospitalized patients with cardiovascular diseases (regression coefficients ranging from 0.61 to 1.20, all P<0.01). Among the machine learning models, XGBoost had the best comprehensive performance (AUC=0.98), which was better than decision tree (AUC=0.66), SVM (AUC=0.95), and neural network (AUC=0.87). Conclusions:The fall risk of hospitalized patients with cardiovascular diseases is jointly affected by physiological, medication and behavioral factors, and the XGBoost model can effectively identify high-risk groups. In actual clinical work, nursing strategies can be optimized in combination with risk factors, and the application of intelligent fall prediction and assessment tools can be promoted.
