پیش‌بینی سکتة مغزی در بیماران همودیالیزی با استفاده از الگوریتم‌های داده‌کاوی

نوع مقاله : مقاله پژوهشی

نویسنده

پژوهشگر پسا دکترا، دانشگاه علوم پزشکی تهران، تهران، ایران

چکیده

«تحلیل داده‌ها» یک مبنای تعیین‌کننده برای تصمیم‌سازی و ایجاد تحول به سمت اهداف مطلوب محسوب می‌شود که یکی از روش‌های مطرح آن داده‌کاوی است. در حوزة سلامت نیز با اجرای داده‌کاوی بر روی بیماران دارای وضعیت حاد «نظیر همودیالیزی‌ها» می‌توان به روندهای آتی آن‌ها تا حدی پی بُرد و به کاهش تشدید عوارضشان کمک کرد. با توجه به اینکه مطالعات سال‌های اخیر حاکی از تشدید ریسک سکتة مغزی در این دسته از بیماران است، هدف از این پژوهش نیز بررسی یک روش مرسوم جراحی در همودیالیزی‌ها و ارتباط آن با بروز سکته است.
روش پژوهش حاضر، استفاده از الگوریتم‌های با ناظر داده‌کاوی و با محوریت «درخت تصمیم» است که از الگوریتم‌های کاربردی در دسته‌بندی متغیرها است و به شناخت عوامل تأثیرگذار کمک می‌کند. داده‌های ورودی شامل 468 بیمار همودیالیزی هستند که در یک دورة پنج ساله مورد مطالعه قرار گرفتند و متشکل از 324 نفر زن و 144 نفر مرد هستند.
این مطالعه نشان داد ریسک ابتلا به سکته مغزی در بیمارانی که جراحی دسترسی عروق آن‌ها با ایجاد کاتتر قبل از فیستول صورت گرفته تا 21/84% بوده درحالی‌که بین سن بیماران دیالیزی با سکته‌شان رابطة معناداری پیدا نشد، اما علاوه بر تعبیة کاتتر، سابقة داشتنِ فشارخون یا دیابت نیز در ابتلا به سکتة مغزی مؤثر بودند.

کلیدواژه‌ها


عنوان مقاله [English]

Predicting Stroke in Hemodialysis Patients Using Data Mining

نویسنده [English]

  • Mohammad Rezapour
Post-Doctoral Researcher, Tehran University of Medical Sciences, Tehran, Iran
چکیده [English]

Data analysis has a fundamental role in decision making process and one effective way to do this is through data mining. In the field of health, by performing data mining on patients with acute conditions such as hemodialysis (HD), their future trends can be partially understood which helps to reduce the severity of their complications. Given that recent studies indicate an increased risk of stroke in HD patients, the aim of this study is to investigate a conventional surgical procedure in hemodialysis and its relationship with stroke.
The method of the present study is the use of supervised data mining algorithms and with the focus on the "decision tree", which is one of the applied algorithms in the classification of variables and helps to identify the influential factors. The input data included 468 of hemodialysis patients who were studied over a five-year period and consisted of 324 females and 144 males.
This study showed that the risk of stroke in patients whose vascular access surgery was performed by catheterization before fistula was 84.21%, while there was no significant relationship between the age of dialysis patients and their stroke, but in addition to catheter implantation, history of blood pressure or diabetes were also linked to stroke.

کلیدواژه‌ها [English]

  • Prediction
  • Data Mining
  • Stroke
Adamus R, Beyer-Enke S, Otte P, Loose R. (2002). Ultrasound-guided puncture of the subclavian vein to implant central venous ports. Rofo 2002;174(11):1450-3.
Boyd R, Saxe A, Phillips E. (1996). Effect of patient position upon success in placing central venous catheters. Am J Surg 1996;172(4):380-2.
Dionigi R, Guaglio R, Bonera A, Cerri M, Rondanelli R, Mishel N, et al. (1979). Clinical-pharmacological aspects, application and effectiveness of total parenteral nutrition in surgical patients. Int J Clin Pharmacol Biopharm 1979;17(3):107-18.
Eifinger F, Brisken K, Roth B, Koebke J. (2011). Topographical anatomy of central venous system in extremely low-birth weight neonates less than 1000 grams and the effect of central venous catheter placement. Clin Anat 2011;24(6):711-6.
Heidari, H., Razavi, F., Mousakhani, M., & Zandi, Y. G. (2017, March). A scientometric analysis of big data literature. In 2017 5th Iranian Joint Congress on Fuzzy and Intelligent Systems (CFIS) (pp. 41-45). IEEE.Hou WY, Sun WZ, Chen YA, Wu SM, Lin SY. (1994). "Pinch-off sign" and spontaneous fracture of an implanted central venous catheter: report of a case. J Formos Med Assoc 1994;93 Suppl 1: S65-9.
Jung CW, Bahk JH, Kim MW, Lee KH, Ko H. (2002). Head position for facilitating the superior vena caval placement of catheters during right subclavian approach in children. Crit Care Med 2002;30(2):297-9.
Knofler R, Dinger J, Kabus M, Müller D, Lauterbach I, Deflomp B, et al. (2001). Thrombolytic therapy in children--clinical experiences with recombinant tissue-plasminogen activator. Semin Thromb Hemost 2001;27(2):169-74.
Liao KM, Huang YB, Chen CY, Kuo CC. (2019 Dec 1). Risk of ischemic stroke in patients with prostate cancer receiving androgen deprivation therapy in Taiwan. BMC cancer. 2019 Dec 1;19(1):1263.
Manfo FP, Chao WF, Moundipa PF, Pugeat M, Wang PS. (2011). Effects of maneb on testosterone release in male rats. Drug Chem Toxicol 2011;34(2):120-8.
Mashima H, Katano M, Iyama A, Hamamoto T, Imoto A, Smith F, et al. (1992). Intra-arterial chemotherapy with granulocyte colony-stimulating factor for breast cancer before surgical treatment. Gan to Kagaku Ryoho 1992; 19:1609-12.
Mercadal L, Du Montcel ST, Jaudon MC, Hamani A, Izzedine H, Dividson M, et al. (2002). Ionic dialysance vs urea clearance in the absence of cardiopulmonary recirculation. Nephrol Dial Transplant 2002;17(1):106-11.
Nayak-Rao S, Shenoy MP. (2017). Stroke in patients with chronic kidney disease…: How do we approach and manage it?. Indian journal of nephrology. 2017 May;27(3):167.
Olesen KK, Madsen M, Gyldenkerne C, Thrane PG, Würtz M, Thim T, Jensen LO, Eikelboom J, Bøtker HE, Sørensen HT, Maeng Met al. (2019 Dec). Diabetes mellitus is associated with increased risk of ischemic stroke in patients with and without coronary artery disease. Stroke. 2019 Dec;50(12):3347-54.
Rezapour M, (2020). Now, Data Mining. Dibagaran; Tehran. Vol 1. Chapters 3-4.
Rezapour M, Ansari N.N, Khavanin Zadeh M, Ghabaee M. (2020). Central Venous Catheter placement increases Cerebrovascular Accident risk in Hemodialysis patients. WoCoVa 2020.
Rezapour M, Payani E, Taran M, Ghatari AR, Zadeh MK. (2017). Roles of triglyceride and phosphate in atherosclerosis of diabetic hemodialysis patients. Medical journal of the Islamic Republic of Iran. 2017; 31:80. [PubMed]
Rezapour M, Taran S, Parast MB, Zadeh MK. (2016). The impact of vascular diameter ratio on hemodialysis maturation time: Evidence from data mining approaches and thermodynamics law. Medical journal of the Islamic Republic of Iran. 2016; 30:359. [PubMed]
Rezapour M, Zadeh MK, Sepehri MM, et al. (2018 Mar 27:) Less primary fistula failure in hypertensive patients. J Hum Hypertens, 2018 Mar 27:1. [PubMed]
Rezapour M. (2018 Feb 1). Forecasting Surgical Outcomes Using a Fuzzy-Based Decision System. Intl J Hospital Res. 2018 Feb 1, 7:1-6. [Link]
Scheepe JR, Van Den Hoek J, Jünemann KP, Alken P. (2007). A standardised mini pig model for in vivo investigations of anticholinergic effects on bladder function and salivation. Pharmacol Res 2007;55(5):450-4.
Rezapour, M., Nakhostin Ansari, N., Khavanin Zadeh, M., & Asadi, R. (2020). Risk of Stroke in Hypertensive Diabetic Chronic Kidney Disease Patients after Central Venous Catheter placement. Razi Journal of Medical Sciences, 27(8).
Stellflug JN. (2006). Comparison of cortisol, luteinizing hormone, and testosterone responses to a defined stressor in sexually inactive rams and sexually active female-oriented and male-oriented rams. J Anim Sci 2006;84(6):1520-5.
Uystepruyst C, Coghe J, Dorts T, Harmegnies N, Delsemme MH, Morisone K, et al. (2002). Sternal recumbency or suspension by the hind legs immediately after delivery improves respiratory and metabolic adaptation to extra uterine life in newborn calves delivered by caesarean section. Vet Res 2002;33(6):709-24.
Yevzlin AS, Song GU, Sanchez RJ, Becker YT. (2007). Fluoroscopically guided vs modified traditional placement of tunneled hemodialysis catheters: clinical outcomes and cost analysis. J Vasc Access 2007; 8(4):245-51.
Zarse M, Plisiene J, Mischke K, Schimpf T, Knackstedt C, Ransone R, et al. (2005). Selective increase of cardiac neuronal sympathetic tone: a catheter-based access to modulate left ventricular contractility. J Am Coll Cardiol 2005;46(7):1354-9.