Construction and Application of a Risk Prediction Model for Linezolid-Related Thrombocytopenia
Objective To establish a combined factor risk prediction model for linezolid-related thrombocytopenia,and to predict the time of first therapeutic drug monitoring(TDM)according to the combined factor risk threshold.Methods A total of 149 patients with infectious diseases treated with linezolid from January 2017 to January 2022 in a Grade-A hospital in Xinjiang were selected and divided into the thrombocytopenia group(n=61)and the non-thrombocytopenia group(n=88)according to whether they had thrombocytopenia or not.The risk factors associated with linezolidin-related thrombocytopenia were screened by the Logistic regression analysis,and a combined factor risk prediction model was established.The time of the first TDM was predicted and validated according to the the combined factor risk threshold.Results A total of 61 patients(40.94% )developed thrombocytopenia,and the course of treatment≥12 d[OR=6.620,95% CI(2.338,18.74),P<0.001],epidermal growth factor receptor(eGFR)≤60 mL/(min·1.73 m2)[OR=7.352,95% CI(1.723,31.37),P=0.007],and creatinine clearance rate(CCr)≤60 mL/min[OR=4.464,95% CI(1.349,14.77),P=0.014]were independent risk factors for linezolidin-related thrombocytopenia.The area under the receiver operating characteristic(ROC)curve(AUC)of the combined factors(course of treatment and CCr)was 0.904 2,with a 95% CI of 0.856 6-0.9519,a sensitivity of 86.89%,a specificity of 80.68%,and a critical value of 4.871.The risk threshold for determining the combined factors was 5.0.Conclusion The combined factor risk prediction model has good diagnostic efficacy,which can be used to reverse predict the time of the first TDM,and improve the effectiveness and safety of the clinical application of linezolid.
linezolidthrombocytopeniarisk factorstherapeutic drug monitoringrisk prediction model
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