Risk factors for hematuria during indwelling urinary catheterization in acute myocardial infarction: a comparative analysis using logistic regression and decision tree.

OBJECTIVE

This study aimed to systematically identify risk factors for urinary catheter-related hematuria in patients with acute myocardial infarction (AMI). By integrating logistic regression and decision tree models, we sought to develop actionable strategies for risk stratification and complication prevention.

METHODS

A retrospective analysis of 209 AMI patients was conducted to evaluate predictors of hematuria, including demographics, coagulation indices (INR, platelets), and procedural variables. Logistic regression and decision tree (CART algorithm) models were employed to identify risk factors and their interactions. Model performance was assessed using ROC-AUC, sensitivity, and specificity.

RESULTS

The incidence of catheter-related hematuria was 32.5%. Both models identified persistent agitation during catheter indwelling and PLT ≤ 246 as common predictors. The logistic regression model specifically identified Gender (OR = 0.202), patient awareness of catheter purpose and precautions (OR = 0.470), and emergency catheter placement (OR = 2.257) as significant factors. The decision tree model uniquely identified INR > 0.955 and repeated complaints of urethral pain as predictors.

CONCLUSION

Hematuria in AMI patients results from coagulation dysfunction, procedural trauma, and behavioral factors. The combined use of logistic regression and decision trees enhances risk stratification. Clinical strategies should prioritize gentle catheterization, dynamic coagulation monitoring, and patient education to reduce complications.