Analysis of risk factors and construction of a risk prediction model for drug-induced thrombocytopenia
Objective To investigate the clinical characteristics and risk factors of drug-induced thrombocytopenia(DITP)and establish a risk prediction model for DITP.Methods The occurrence of DITP in hospitalized patients from January to December 2021 in the Chinese PLA General Hospital was retrospectively analyzed using the adverse drug events active surveillance and assessment system-Ⅱ.Propensity score matching(PSM)was applied to match 3 control cases for each positive case.Predictor variables were screened through univariate analysis combined with the maximum likelihood ratio test,and a nomogram prediction model for DITP was constructed.Results A total of 88 151 hospitalized patients were monitored,and 478(0.5%)were diagnosed as DITP-positive cases.A total of 87 suspected drugs were involved,mainly including antineoplastic drugs(57.3%,274/478),antimicrobials(25.1%,120/478),and antithrombotic drugs(12.6%,60/478).After PSM,382 patients were in the DITP group and 1146 patients were in the N-DITP group.Multivariate logistic regression analysis showed that hospital stay≥14 days,concomitant use of antimicrobials,and baseline γ-glutamyltransferase(GGT)≥50 U/L were risk factors for DITP,while baseline platelet count(PLT)≥150×109/L was a protective factor(P<0.05).These four variables were used to construct a nomogram model,with the AUC of 0.821(95%CI:0.799 to 0.844),and the calibration curve indicated good calibration of the nomogram model(P>0.05).Conclusion The main drugs causing DITP in hospitalized patients are antineoplastic drugs,antimicrobials,and antithrombotic drugs.The nomogram model based on hospital stay,concomitant use of antimicrobials,baseline GGT and PLT can help predict the risk of DITP,providing a reference for the prevention and treatment of DITP.
drug-induced thrombocytopeniarisk factorsnomogramprediction modeladverse drug reaction
NETL
NSTL
万方数据
