基于LASSO–logistic回归的乳腺癌病人重返工作影响因素分析

    Analysis of influencing factors for return to work in breast cancer patients based on LASSO-logistic regression

    • 摘要:
      目的: 探讨乳腺癌病人术后重返工作(RTW)的现状,并基于LASSO–logistic回归模型分析其影响因素,为制定个性化康复干预策略提供依据。
      方法: 采用便利抽样法纳入397例乳腺癌术后病人,分为RTW组(n = 140)和未RTW组(n = 257)。采用单因素分析初筛候选变量,继而引入LASSO回归以L1正则化实现变量压缩与共线性消除,最终通过多因素logistic回归确定RTW的独立影响因素。
      结果: RTW发生率为35.3%(140/397)。单因素分析显示20个候选变量存在组间差异(P < 0.05)。将上述变量纳入LASSO回归分析,当λ = 0.029 8时,筛选出7个非零系数变量。将lasso筛选出的7个变量纳入多因素logistic回归分析,结果显示:从事脑力劳动职业(OR = 16.041)、社会支持评分高(OR = 1.114)是RTW的促进因素;癌症疲乏评分高(OR = 0.784)和患侧行腋窝淋巴结清扫(OR = 0.396)是RTW的阻碍因素。
      结论: 乳腺癌术后病人RTW受生理、心理及社会支持等多维度因素影响,实施多维度个性化干预对促进病人RTW具有积极意义。

       

      Abstract:
      Objective To investigate the current status of return to work (RTW) in postoperative breast cancer patients, and to analyze its influencing factors based on the LASSO-Logistic regression model, so as to provide a basis for developing personalized rehabilitation intervention strategies.
      Methods A total of 397 postoperative breast cancer patients were enrolled using convenience sampling and divided into an RTW group (n = 140) and a non-RTW group (n = 257). Univariate analysis was used for initial screening of candidate variables, followed by LASSO regression with L1 regularization to achieve variable compression and eliminate multicollinearity. Finally, multivariate logistic regression was conducted to identify the independent influencing factors of RTW.
      Results The RTW rate was 35.3% (140/397). Univariate analysis revealed significant inter-group differences in 20 candidate variables (P < 0.05). These variables were subsequently incorporated into the LASSO regression analysis, which identified 7 variables with non-zero coefficients at λ = 0.029 8. The 7 variables selected by LASSO were then included in a multivariate logistic regression analysis, which showed that engaging in a mental-labor occupation (OR = 16.041) and higher social support scores (OR = 1.114) were promoting factors for RTW, while higher cancer-related fatigue scores (OR = 0.784) and ipsilateral axillary lymph node dissection (OR = 0.396) were impeding factors.
      Conclusions RTW among post-operative breast cancer patients is affected by multi-dimensional factors including physiological, psychological and social support elements. Implementing multi-dimensional personalized interventions is of positive significance for facilitating patients' return to work.

       

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