Analysis of risk factors and construction of risk prediction model for batroxobin-related severe hypofibrinogenemia
- VernacularTitle:巴曲酶相关严重低纤维蛋白原血症的危险因素分析及风险预测模型构建
- Author:
Le CAI
1
;
Yuqing ZHAO
2
;
Jiazhu CUI
3
;
Xiao WEN
1
;
Daihong GUO
1
;
Man ZHU
1
Author Information
1. Dept. of Pharmacy，Medical Supplies Center of Chinese PLA General Hospital，Beijing 100853，China
2. School of Pharmacy，Bengbu Medical University，Anhui Bengbu 233030，China
3. School of Life Sciences and Biopharmaceuticals，Shenyang Pharmaceutical University，Shenyang 110016，China
- Publication Type:Journal Article
- Keywords:
batroxobin;
hypofibrinogenemia;
risk prediction model;
nomogram;
risk factors
- From:
China Pharmacy
2026;37(4):462-467
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the clinical characteristics and risk factors for batroxobin-related severe hypofibrinogenemia （HFIB） and construct a risk prediction model. METHODS A retrospective analysis was conducted on inpatients treated with batroxobin in the First Medical Center of a tertiary hospital from January 1， 2020， to December 31， 2024. Patients were categorized into non-severe HFIB group and severe HFIB group based on the severity of HFIB. Univariate and multivariate Logistic regression analyses were performed to identify the independent influencing factors for batroxobin-related severe HFIB. A nomogram was developed using the “rms” package in R 4.5 software. The predictive performance of the model was evaluated using the receiver operating characteristic curve. Calibration was assessed via the Bootstrap resampling method， and goodness-of-fit was evaluated with the Hosmer-Lemeshow test. RESULTS A total of 1 472 patients were included in this study. Of these， 1 445 developed HFIB， yi elding an incidence of 98.17%. Furthermore， 895 were classified as severe HFIB， accounting for 60.80% of the cohort. Multivariate Logistic regression analysis showed that increased age， high initial dose per 10 kg body weight， use of maintenance dose， and concomitant glucocorticoid use were independent risk factors for batroxobin-related severe HFIB， while high baseline fibrinogen （FIB） level was identified as a protective factor. The model demonstrated an area under the curve of 0.760 （95% CI： 0.735-0.785）. The mean absolute error of the calibration curve was 0.006. The P value of the Hosmer-Lemeshow test was 0.609. CONCLUSIONS Batroxobin can rapidly and significantly reduce FIB levels and carries a risk of inducing severe HFIB. Patients with advanced age， high initial dose per 10 kg body weight， use of maintenance dose and concomitant glucocorticoid use had a higher risk of batroxobin-related severe HFIB， while high baseline FIB level had a lower risk of batroxobin-related severe HFIB. The risk prediction model developed based on these factors can be used to predict the likelihood of batroxobin-related severe HFIB.
