Risk Factors of Augmented Renal Clearance in Critically-Ill Elderly Patients Administered with Cefoperazone Sodium and Sulbactam Sodium for Injection
OBJECTIVE:To probe into the risk factors of augmented renal clearance(ARC)in critically-ill elderly patients administered with cefoperazone sodium and sulbactam sodium for injection.METHODS:The hospitalization information of 286 elderly patients admitted into the hospital from 2018 to 2022 was retrospectively analyzed,all patients were divided into 97 cases in the ARC group and 189 cases in the control group according to whether to develop ARC.Logistic regression analysis was used to screen factors related to the occurrence of ARC,and receiver operating characteristic curve(ROC curve)was used to analyze the predictive effect of risk factors on ARC.RESULTS:(1)The incidence of ARC of the research objects was 33.92%,the patients'age,white blood cell count,urea nitrogen,creatinine and SOFA score of the ARC group were significantly lower than those of the control group,the number of eosinophils,creatinine clearance rate,glomerular filtration rate,number of patients with craniocerebral trauma history,number of complications and number of patients with systemic inflammatory response syndrome(SIRS)of the ARC group were significantly higher than those of the control group,the ICU treatment time of the ARC group was significantly longer than that of the control group,with statistically significant differences(P<0.05).(2)The median steady-state valley concentration of the ARC group was significantly lower than that of the control group(5.36 μmol/mL vs.14.12 μmol/mL),with statistically significant difference(χ2=10.182,P<0.05);the treatment effective rate of the ARC group was significantly lower than that of the control group[38.14%(37/97)vs.56.08%(106/189)],with statistically significant difference(χ2=8.662,P<0.05).(3)The results of Logistic regression analysis indicated that craniocerebral trauma history,number of complications,SOFA score and proportion of SIRS were positively associated with the occurrence of ARC,and age was negatively associated with the occurrence of ARC.(4)The results of ROC curve indicated that age,craniocerebral trauma history and SOFA score had better predictive effects.CONCLUSIONS:Critically-ill elderly patients with lower age,craniocerebral trauma history and lower SOFA scores are more likely to develop ARC after administered with cefoperazone sodium and sulbactam sodium for injection,and the risk of ARC should be comprehensively assessed during the treatment of this group of patients,and the therapeutic regimen should be adjusted in time.
ElderlyCritically illCefoperazone sodium and sulbactam sodium for injectionAugmented renal clearance
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