- 期刊
冠狀動脈心臟病危險因子之老年人心導管檢查預測模型研究
Establishing a Prediction Model for Coronary Angiography Based on the Coronary Risk Factors in the Elderly
摘要
目標：爲了嘗試建立一套可協助醫師決定是否進行老年人心導管檢查的診斷指引，我們利用冠狀動脈心臟病之危險因子以決策樹之模型、定義出具有不同程度及類別危險因子之病患其罹患冠狀動脈心臟病之機率。 方法：我們搜集2003年1月至2005年6月二區域醫院老年人爲了檢查是否罹患冠狀動脈心臟疾病所進行之心導管檢查全民健保申報個案1,288筆，並以卡方自動互動偵測法進行分析。 結果：在1,228位樣本中，有334位(25.9%)心導管檢查結果爲陰性。在所有11個變項中，「性別」是最能夠預測罹患顯著冠狀動脈心臟疾病與否的變項，其餘依序爲高血壓、糖尿病、年齡、缺乏運動及吸菸等本研究亦可顯示不同風險變項間之交互作用。本研究之敏感度爲90.7%；特異度爲70.0%；陽性預測值爲91.2%。 結論：本研究顯示依冠狀動脈心臟疾病危險因子做出之老年人心導管檢查預測模型，可輔助臨床醫師做決策。
並列摘要
Objectives: This study aims at developing an effective, evidence-based diagnostic guideline for improving the accuracy in the prescription of coronary angiography for elderly patients. Methods: The sample consisted of 1,288 elderly patients receiving coronary angiography at two regional hospitals during the period from January 2003 to June 2005. Selection of the patients was based on the claim forms provided by the Bureau of National Health Insurance in Taiwan. Chi-square automatic interaction detection was applied to analyze the results for identifying risk factors of coronary artery disease in elderly patients. Results: There was 334 subjects (25.9%) shown negative by coronary angiography. We found the risks of developing coronary heart disease varying according to risk factors such as sex, hypertension, diabetes, age, sedentary life and smoking. The study also uncovered the interactions among patients' risk factors. The sensitivity, specificity and positive predictive value of our study were 90.7%, 70.0% and 91.2% respectively. Conclusions: The results of this study suggest that the decision making of cardiac angiography prescription can be significantly determined by an evidence-based effective guideline on related risk factors in elderly patients.
被引用紀錄
延伸閱讀
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