关键词: 慢性心力衰竭, 社会衰弱, 影响因素分析, SVM-RFE, SHAP

Abstract: Background The integrated management of heart failure with frailty poses a multidimensional need for frailty assessment, but as an incremental predictor of adverse health outcomes in patients with heart failure, the social dimension of frailty has not received sufficient attention. Objective To understand the status of social frailty in patients with chronic heart failure and analyze its influencing factors. Methods From September 2022 to July 2023, convenience sampling was used to select 213 patients with chronic heart failure from a ClassΙΙΙ Grade A hospital in Nanjing as the research objects, the general information questionnaire, HALFT Scale, Loneliness Scale, the Brief 2-Way Social Support Scale, Personal Mastery Scale, and the Patient Health Questionnaire were used to investigate. Univariate analysis and support vector machine-feature recursive elimination were used to filter the feature, the SVM classification model was constructed, and the SHAP value was introduced to analyze the influencing factors. Results The proportion of pre-social frailty and social frailty in patients with chronic heart failure was 46% and 17.8%, respectively. When the SVM-RFE model plays the best performance, the optimal feature subset was used to construct the SVM classification prediction model and perform SHAP interpretability analysis. The accuracy of the model was 0.73 in the training set and 0.63 in the test set, respectively. At this time, the ranking of feature importance from high to low was no exercise habit (+), personal mastery (-), heavy economic burden of disease (+), 2-way social support (-), depression (+), loneliness (+), unemployment (+). Conclusion Chronic heart failure patients with serious social frailty problems. Medical staff should pay attention to the missing resource attributes of patients and their upstream factors, take targeted interventions to delay or reverse the process of social frailty by strengthening the external support system, cultivating inner beliefs, overcoming negative emotional experiences, making overall management plans, integrating medical resources and implementing interventions to delay or reverse the process of social frailty in patients with heart failure, improving their prognosis and quality of life.

Key words: Chronic heart failure, Social frailty, Root cause analysis, SVM-RFE, SHAP