Construction and evaluation of a risk prediction model for linezolid-related neurological adverse reactions in patients with multidrug-resistant tuberculosis
10.3969/j.issn.1006-5725.2024.19.005
- VernacularTitle:耐多药肺结核患者发生利奈唑胺相关神经系统不良反应风险预测模型的构建与评价
- Author:
Haojie TANG
1
;
Zilong YANG
;
Zhaoxian YU
;
Zhiyu FENG
;
Haiping DONG
;
Xiang LI
;
Wei ZHAO
;
Haobin KUANG
Author Information
1. 广州市胸科医院 重症医学科(广东广州 510095)
- Keywords:
linezolid;
multidrug-resistant;
pulmonary tuberculosis;
nervous systemadverse reactions;
prediction model
- From:
The Journal of Practical Medicine
2024;40(19):2690-2695
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the determinants of linezolid-associated neurological adverse reactions in patients with multidrug-resistant tuberculosis and develop a risk prediction model for such adverse events.Methods A prospective cohort study design was employed to select 120 patients with drug-resistant pulmonary tuberculosis who received a chemotherapy regimen containing linezolid at Guangzhou Chest Hospital from April 2023 to January 2024 as the study population.Clinical data,adverse reactions,and plasma concentration of linezolid were collected during fasting and at 2 hours post-medication.Univariate analysis and multivariate logistic regression were conducted to identify factors influencing linezolid-related neurological adverse reactions.Furthermore,a prediction model for such adverse reactions was developed,and its predictive efficacy and calibration ability were evaluated using ROC analysis.Results Re-treatment(OR=2.540,P=0.028),coexistence of cavities(OR=4.092,P=0.021),anemia(OR=10.921,P=0.005),and Cmin≥0.7665 mg/L(OR=6.813,P<0.001)are independent risk factors for the occurrence of linezolid-related neurological adverse reactions.The prediction model,based on these four factors,exhibits an AUC of 0.851(95%CI:0.774～0.929),accompanied by a Youden index of 0.590,a sensi-tivity of 66.7%,and a specificity of 92.3%.Moreover,the prediction model demonstrates excellent calibration ability.(Hosmer-lemeshow χ2=8.719,P=0.273).Conclusion In MDR/RR-TB patients,the presence of cavita-tion,retreatment,and anemia may confer a heightened risk of linezolid-related neurological adverse reactions.A risk prediction model incorporating these four indicators demonstrates significant predictive value for the occurrence of such adverse events.
