융합정보논문지 (Journal of Convergence for Information Technology)

중소기업융합학회 (Convergence Society for SMB)
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의사결정나무분석을 이용한 심혈관질환자의 재입원 위험 요인에 대한 융합적 분석

Convergence Analysis of Risk factors for Readmission in Cardiovascular Disease: A Machine Learning Approach

  • Kim, Hyun-Su (Department of Nursing, KyungDong University)
  • 투고 : 2019.11.11
  • 심사 : 2019.12.20
  • 발행 : 2019.12.28
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초록

본 연구는 의사결정나무 통계분석법을 톨해 국민건강영양조사 자료를 2차 분석하여 심혈관질환자의 재입원 위험 요인을 확인하는 기초자료를 마련하고자 하였다. 연구대상자는 국민건강영양조사 4-6기 자료대상자 총 65,973명 중 협심증이나 심근경색 진단 병력이 있는 총 1,037명의 성인이며, SPSS window 21 Program을 이용하여 분류 분석 중 CHAID 의사결정나무 방법으로 분석하였다. 뿌리 마디(Root node)는 경제활동상태((χ2=12.063, p=.001), 자식 마디(Child node)는 개인 소득수준(χ2=6.575, p=.031), 최근 1년간 체중 변화(χ2=12.758, p=.001), 거주지역(χ2=4.025, p=.045), 직접흡연(χ2=3.884, p=.049), 교육수준(χ2=9.630, p=.024)으로 확인되었다. 끝마디(Terminal node)는 고혈압(χ2=3.854, p=.050), 당뇨(χ2=6.056, p=.014), 직업형태(χ2=7.799, p=.037)로 분석되었다. 이를 통해 심혈관질환자의 재입원 관리를 위해 다양한 요인의 통합적 접근을 고려한 프로그램의 개발 및 운영이 필요함을 제언한다.

This is descriptive study to 2nd analysis data KNHANES IV-VI about risk factors of readmission among patients with cardiovascular disease. Among the total 65,973 adults, 1,037 with angina or myocardial infarction were analyzed. The analysis was conducted using SPSS window 21 Program and CHAID decision tree was used in the classification analysis. Root nodes are economic activity(χ2=12.063, p=.001), children's nodes are personal income(χ2=6.575, p=.031), weight change(χ2=12.758, p=.001), residential area(χ2=4.025, p=.045), direct smoking(χ2=3.884, p=.031). p=.049), level of education(χ2=9.630, p=.024). Terminal nodes are hypertension(χ2=3.854, p=.050), diabetes mellitus(χ2=6.056, p=.014), occupation type(χ2=7.799, p=.037). We suggest that the development and operation of programs considering the integrated approach of various factors is necessary for the readmission management of cardiovascular patients.

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참고문헌

  1. J. O. Jung. (2013). Regional Cardiocerebrovascular Center Project in the Treatment of Acute Myocardial Infarction. The Korean Association of Internal Medicin, 85(3), 272-274.
  2. Statistics Korea. (2014). Disease statistics report.
  3. E. H Gil. (2013). Differences in Adherence to Self - Care, Drug Compliance, and Knowledge of Heart Failure Based on Rehospitalization of Heart Failure Patients. MD, Eulji University, Daejeon.
  4. S. J. Son, S. H. Kim, & K. Y. Kim. (2011). Factors influencing adherence to self care in patients with chronic heart failure. Journal of Korean Academy of Adult Nursing, 23(3), 244-254.
  5. F. Braunschweig, M. Cowie & A. Auricchio. (2011). What are the costs of heart failure?. Europace, 13(2), 13-17.
  6. N. Hawkins, P. Jhund, J. McMurray & S. Capewell. (2012). Heart failure and socioeconomic status: accumulating evidence of inequality. European journal of heart failure, 14(2), 138-146. https://doi.org/10.1093/eurjhf/hfr168
  7. P. Tansey. (2010). Counting the cost of heart failure to the patient, the nurse and the NHS. British Journal of Nursing, 19(22), 1396-1401. https://doi.org/10.12968/bjon.2010.19.22.1396
  8. Y. M. No. (2002). The Importance of Prevention and Treatment of Cardiovascular Disease. Korea association of health promotion, 26(12), 4-5.
  9. D. Hiba, H. Skouri, & S. Noureddine. (2016). Readmission rates and related factors in heart failure patients: A study in Lebanon, COLLEGIAN, 23(1), 61-68 https://doi.org/10.1016/j.colegn.2014.11.001
  10. H. N. Lee. (2014). Risk Factors assoiated with the readmission of the spinal surgery patients. MD, Yonsei University, Seoul.
  11. H. S. Lee, & H. J. Lee. (2015). Convergence Factors of affecting Rehospitalization of Tuberculosis Patients. Journal of Digital Convergence, 13(5), 259-267. https://doi.org/10.14400/JDC.2015.13.5.259
  12. S. Smith, J. Allen, S. Blair, R. Bonow, L. Brass, G. Fonarow & L. Mosca. (2006). AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Journal of the American College of Cardiology, 47(10), 2130-2139. https://doi.org/10.1016/j.jacc.2006.04.026
  13. T. Jaarsma, K. Arestedt, J. Martensson, K, Dracup & A. Stromberg. (2009). The European Heart Failure Self‐care Behaviour scale revised into a nine‐item scale(EHFScB9): a reliable and valid international instrument. European journal of heart failure, 11(1), 99-105. https://doi.org/10.1093/eurjhf/hfn007
  14. Y. T. Jeon & H. J. Choi. (2019). Model based hybrid decision tree. the Korean data information science society, 30(3), 515-524. https://doi.org/10.7465/jkdi.2019.30.3.515
  15. J. S. Kang, J. W. Baek & K. Y. Chung. (2019). Multimodal Media Content Classification using Keyword Weighting for Recommendation. Journal of Convergence for Information Technology, 9(1), 1-6. https://doi.org/10.22156/CS4SMB.2019.9.1.001
  16. H. S. Kim & H. Y. Kim. (2018). Factors Affecting the Control of HbA1c in Type 2 Diabetic Patients. Journal of Convergence for Information Technology, 8(6), 75-84. https://doi.org/10.22156/CS4SMB.2018.8.6.075
  17. R. Kociol, R. Lopes, R. Clare, L. Thomas, R. Mehta, P. Kaul, & C. Granger. (2012). International variation in and factors associated with hospital readmission after myocardial infarction. JAMA, 307(1), 66-74. https://doi.org/10.1001/jama.2011.1926
  18. S. U. Lee et al. (2014). Environmental Exposure and Health Inequality by Socio-economic Position among Older People. The Korean Gerontologic society, 34(2), 349-367.
  19. N. Dragano, B. Hoffmann, S. Moebus, S. Möhlenkamp, A. Stang, P. E. Verde & J. Siegrist. (2009). Traffic exposure and subclinical cardiovascular disease: is the association modified by socioeconomic characteristics of individuals and neighbourhoods? Results from a multilevel study in an urban region. Occupational and environmental medicine, 66(9), 628-635. https://doi.org/10.1136/oem.2008.044032
  20. U. Subramanian, F. Hopp, A. Mitchinson & J. Lowery. (2009). Impact of Provider Self‐ Management Education, Patient Self-Efficacy, and Health Status on Patient Adherence in Heart Failure in a Veterans Administration Population. Congestive Heart Failure, 30(6), 415-425.
  21. S. R. Kim, O. K. Kim, K. E. Yun, Y. H. Khang & H. J. Cho. (2009). Socioeconomic Factors Associated with Initiating and Quitting Cigarette Smoking Among Korean Men. The Journal of the Korean Academy of Family Medicine, 14(1), 6-11.
  22. S. H. Choi. (2019). The Effects of NCS Education and Education Transition on Practical Results. Journal of Convergence for Information Technology, 9(3), 82-89. https://doi.org/10.22156/CS4SMB.2019.9.3.082
  23. I. J. Kim. (2009). Smoking and Cardiovascular Disease in Diabetes Mellitus. Clinical Diabetes Mellitus, 10(6) 76-78.
  24. S. M. Chung & Y. S. Kim. (2019). Effects of high-risk alcohol drinking and smoking on treatment and complications management of diabetes mellitus patients: Cross-sectional study. Korean public health research, 45(3), 13-23. https://doi.org/10.22900/KPHR.2019.45.3.002
  25. O. J. Rhee, M. W. Tae, J. E. Seo & J. I. Kim (2013). The Relationships between the Changes of Socioeconomic Status and Smoking in Employees: Focusing on the Moderating Effect of Gender. Health and Social Welfare Review, 33(3), 59-85. https://doi.org/10.15709/HSWR.2013.33.3.59
  26. M. Lainscak, L. Blue, A. Clark, U. Dahlström, K. Dickstein, I. Ekman & A. Stromberg. (2011). Selfcare management of heart failure: practical recommendations from the Patient Care Committee of the Heart Failure Association of the European Society of Cardiology. European Journal of Heart Failure, 13(2), 115-126. https://doi.org/10.1093/eurjhf/hfq219
  27. B. Eliasson. (2003). Cigarette smoking and diabetes. Progress in cardiovascular diseases, 45(5), 405-413. https://doi.org/10.1053/pcad.2003.00103
  28. E. K. Song, J. J. Kim, I. Y. You, K. Y. Kim, J. H. Kim & J. W. Ha. (2006). Factors Influencing Functional Status in Patients with Heart Failure. Journal of Korean Academy of Nursing, 36(5), 853-862. https://doi.org/10.4040/jkan.2006.36.5.853
  29. B. Galobardes, M. Costanza, M. S. Bernstein, C. Delhumeau & A. Morabia. (2003). Trends in risk factors for the major "lifestyle-related diseases" in Geneva, Switzerland, 1993-2000. Annals of epidemiology, 13(7), 537-540. https://doi.org/10.1016/S1047-2797(03)00055-3
  30. A. Navas-Acien, E. Guallar, E. K. Silbergeld, & S. J. Rothenberg. (2007). Lead exposure and cardiovascular disease: a systematic review. Environmental health perspectives, 115(3), 472-482. https://doi.org/10.1289/ehp.9785