PHN TCH HI QUI LOGISTIC N V A BIN

Phn tch hi qui logistic l mt k thut thng k xem xt mi lin h gia bin c lp (bin s hoc bin phn loi) vi bin ph thuc l bin nh phn. Trong hi qui tuyn tnh n, bin c lp x v ph thuc y l bin s lin tc lin h qua phng trnh: y = + x + Trong hi qui logistic, bin ph thuc y ch c 2 trng thi 1 ( v d t vong) v 0 ( v d sng). Mun i ra bin s lin tc ngi ta tnh xc sut ca 2 trng thi ny. Nu gi p l xc sut mt bin c xy ra (v d: t vong), th 1-p l xc sut bin c khng xy ra (v d: sng). Phng trnh hi qui logistic pht biu: Log (
p 1p

) = + x +

T phng trnh ny, ta c th tnh xc sut tin on t vong theo tr s ca x.

p 1p

= + x
+ x

p=

1+ + x

V d: Nghin cu s lin h gia nng procalcitonin mu v tin lng t vong trong nhim trng huyt. D liu thu thp 20 bnh nhn nh sau:

C 3 ct: ID bnh nhn, PROCALCITONIN mu (ng/ml), DEATH( 0: sng; 1: T vong)

Mun tnh p (xc sut tin on t vong) Vo menu: Analyze> Regression> Binary Logistic

M hp thoi Logistic Regression. Nhp chuyn bin DEATH (nh phn) vo Dependent v bin PROCALCITONIN (bin s lin tc) vo Covariates

Nhp nt Save, m hp thoi Save, nh du nhy vo Predicted Values (y l xc sut tin on t vong). Nhp Continue

Nhp nt Options, m hp thoi Options, nh dy nhy vo CI for exp(B) [khong tin cy ca h s B=chnh l t s odds)

Nhp Continue, nhp OK Kt qu: Trong file d liu, xut hin thm ct PRE-1, y chnh l xc sut tin on t vong trn trc tung (y)

Sau khi c p, v biu lin h gia x (procalcitonin) v y (xc sut p tin on t vong)

Nh vy c s lin h tuyn tnh gia nng procacitonin (trc x) v xc sut d on t vong p (trc y)

T bng kt qu trn ta c th vit phng trnh hi qui logistic: Log (

p 1p

)= -3,079+ 5.037 * procalcitonin

Nh vy c procalcitonin tng ln 1 ng/ml th log ca t l xc sut cht/sng s tng thm 5,037 ln. d din dch, ta c th vit: (
p 1p

)= 3,079 + 5,037.procalcitonin
p 1p

Ta bit

chnh l odd, v vy c th vit:

odd= 3,079 + 5,037.procalcitonin Nu gi odd0 khi procalcitonin=0 th odd0= 3,079 V gi odd1 khi procalcitonin tng ln 1 n v th odd1= 3,079 + 5,037 V t s ca 2 odds chnh l odds ratio: (Xem ct Exp(B) bng trn) Lc ny ta c th din dch, c procalcitonin tng ln 1 ng/ml th nguy c t vong tng ln 154 ln (kt qu exp (B) bng 1, vi 5.037 =153,988) hoc ng hn l c procalcitonin tng thm 0,1 ng/ml th nguy c t vong tng ln 15,4 ln.
Odd 1 Odd 0 e 3,079
+ 5,037

e 3,079

= e5,037 = 153,98

Phn tch hi qui logistic a bin.

By gi nu ta xt n nhiu yu t khc c th c th lm tng nguy c t vong trong nhim trng huyt, v d nh tui bnh nhn, h huyt p, c bnh nn hoc suy gim min dchTrong v d ny ta ch xt n 3 yu t: procalcitonin (bin s), h huyt p (bin nh phn) v tui bnh nhn (bin s). D liu 30 bnh nhn nhim trng huyt nh sau: C 5 ct: ID, Age (tui), Hypotension (h huyt p), Procaltitonin (ng/ml) v Death (t vong)

Vo menu: Analyze> Regression> Binary Logistic

M hp thoi Logistic Regression, Nhp chuyn bin DEATH vo Dependent. Nhp c 3 bin AGE, HYPOTENSION v PROCALCITONIN vo Covariates.

Nhp nt Categorical khai bo bin HYPOTENSION l bin phn loi (hoc nh phn) V khai bo gi tr tham kho ca HYPOTENSION l 1 (c h huyt p): Reference Category l First , Nhp Continue

Sau nhp nt Options, vo hp thoi Options, nh du nhy vo Cl for Exp(B): xem t s odds v khong tin cy 95% ca odds.

Nhp Continue, sau nhp OK. Kt qu nh sau:

Ch ly 3 bng cui cng v c din dch nh sau: Tr s -2 Log likelihood ch ph hp ca m hnh. Tr s ny cng nh th m hnh cng ph hp. Trong m hnh ny vi -2 Log likelihood =14.627 l khng cao lm, nh vy c ph hp kh tt vi m hnh tng th. Vi kt qu ny m hnh hi qui logistic c vit l: Log(
p 1p

) = -3,232 + 0,137. PROCALCITONIN + 0,013. AGE + 4.915. HYPOTENSION

= 3,232+0,137.PROCALCITONIN+0,013.AGE+4,915.HYPOTENSION

Hoc:

p 1p

Nh din dch phn trn: T s odds ca procalcitonin: OR1= 0,137 = 1,147 T s odds ca tui: OR1= e0,013 = 1,013 T s odds ca h huyt p= 4,915 = 136

(Xem 3 ct cui cng bng trn, s thy t s odds v khong tin cy 95%)

Ta c th tm tt trong bng sau: ngha thng k p 0,94 0,82 0,01

Yu t Procalcitonin Tui H huyt p

Odds ratio (OR) 1,14 1,01 136

Khong tin cy 95% 0,03 - 45,20 0,90 - 1,13 3 6447

Kt lun: Ch c h huyt p l yu t c lp dn n t vong bnh nhn b nhim trng huyt vi OR=136 (KTC 95%: 3 6447; p=0,01)

BS Nguyn Ngc Rng, email:rangbvag@yahoo.com Website: bvag.com.vn Ti liu tham kho: 1. Nguyn Vn Tun. 2007. Phn tch hi qui logistic trong: Phn tch s liu v to biu bng R. Nh Xut bn Khoa hc v K thut. trang 215-218. 2. Tripepi G, Jager KJ, Stel VS, Dekker FW, Zoccali C. How to Deal with Continuous and Dichotomic Outcomes in Epidemiological Research: Linear and Logistic Regression Analyses. Nephron Clin Pract. 2011 Feb 23;118(4):c399-c406. 3. Hong Trng v Chu Nguyn Mng Ngc, Phn tch d liu nghin cu vi SPSS. Nh xut bn thng k nm 2005