Decision Tree Algorithm Identifies Stroke Patients Likely Discharge Home After Rehabilitation Using Functional and Environmental Predictors
Decision Tree Algorithm Identifies Stroke Patients Likely Discharge Home After Rehabilitation Using Functional and Environmental Predictors
复制标题
DOI：
10.1016/j.jstrokecerebrovasdis.2021.105636
复制
发表时间：
2021-02-03
影响因子：
2.5
通讯作者：
Araki, Osamu
中科院分区：
文献类型：
--
作者：
Imura, Takeshi;Iwamoto, Yuji;Araki, Osamu
背景与目的：环境因素对脑卒中患者实现居家出院的重要性尚未得到科学证实。应用具有多种功能变量和环境变量的决策树算法识别高出院可能性脑卒中患者的研究有限。本研究旨在利用机器学习方法识别影响脑卒中住院康复后出院的因素，包括功能因素和环境因素。方法：这是一项队列研究，数据来自于本院康复病房所有卒中患者的数据库。共调查了1125例脑卒中患者。我们开发了三个分类回归树（CART）模型来确定住院康复后回家的可能性。结果：在3种模型中，结合基本信息、功能因子和环境因子变量的CART模型对家庭分泌物的识别准确率最高。该模型将上半身的FIM着装（得分为2）确定为家庭出院的第一个单一判别因素。进行房屋翻新与出院的可能性高有关，即使是在FIM评分较差的上半身穿衣能力的中风患者(
Background and purpose: The importance of environmental factors for stroke patients to achieve home discharge was not scientifically proven. There are limited studies on the application of the decision tree algorithm with various functional and environmental variables to identify stroke patients with a high possibility of home discharge. The present study aimed to identify the factors, including functional and environmental factors, affecting home discharge after stroke inpatient rehabilitation using the machine learning method. Method: This was a cohort study on data from the maintained database of all patients with stroke who were admitted to the convalescence rehabilitation ward of our facility. In total, 1125 stroke patients were investigated. We developed three classification and regression tree (CART) models to identify the possibility of home discharge after inpatient rehabilitation. Results: Among three models, CART model incorporating basic information, functional factor, and environmental factor variables achieved the highest accuracy for identification of home discharge. This model identified FIM dressing of the upper body (score of 2) as the first single discriminator for home discharge. Performing house renovation was associated with a high possibility of home discharge even in patients with stroke who had a poor FIM score in the ability to dress the upper body (