Construction of risk prediction model of dysphagia in elderly patients with COPD
CHEN Yiping
DING Meizhu
SHAO Sayun
ZHOU Xun
HE Wenfang
Abstract：Objective:To analyze the influencing factors of dysphagia in elderly patients with chronic obstructive pulmonary disease(COPD)and to construct Logistic regression model and decision tree risk prediction model.Methods:A total of 250 elderly patients with COPD admitted to our hospital for treatment were selected as the research subjects from July 2021 to July 2023.The patient information was investigated by patient information questionnaire.Influencing factors of dysphagia in elderly patients with COPD was analyzed by Logistic regression.Decision tree model than Logistic regression model of dysphagia in elderly patients with COPD was constructed,and its predictive performance for dysphagia in elderly patients with COPD was analyzed.Results:Among 250 elderly patients with COPD,120 developed dysphagia,with dysphagia incidence rate of 48%.The results of Logistic regression analysis showed that loss of≥6 teeth,with malnutrition,with cognitive impairment,with oral weakness,and moderate to severe COPD were risk factors of dysphagia in elderly patients with COPD(P<0.05).Decision tree model was constructed with a total of 6 layers and 17 nodes,5 explanatory variables were selected,namely teeth loss,nutritional status,cognitive impairment,oral weakness,and severity of COPD.Among them,nutritional status was the most important influencing factor of dysphagia in elderly patients with COPD.The area under the curve(AUC)of receiver operator characteristic of the Logistic regression model of dysphagia in elderly patients with COPD was 0.682(95%CI 0.620-0.739),and the AUC of the decision tree model was 0.747(95%CI 0.689-0.800).The Delong test results for both models showed that Z=3.118,P=0.001.Conclusions:The incidence of dysphagia in elderly patients with COPD is relatively high,and loss of≥6 teeth,with malnutrition,with cognitive impairment,with oral weakness,and moderate to severe COPD were risk factors of dysphagia in elderly patients with COPD.The decision tree model constructed has higher predictive performance than Logistic regression model,it can provide reference for dysphagia in elderly patients with COPD and develop targeted preventive nursing interventions.
Keywords：elderly peoplechronic obstructive pulmonary diseaseCOPDdysphagiainfluencing factorsdecision tree modelpreventive nursing
Publication Date：2025-01-24
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 204-210 )