Study on the correlation between vancomycin therapeutic drug monitoring and short-term and long-term prognosis in sepsis patients based on the MIMIC-Ⅳ database
10.12173/j.issn.1005-0698.202501021
- VernacularTitle:基于MIMIC-Ⅳ数据库的万古霉素治疗药物监测与脓毒症患者短期和长期预后相关性研究
- Author:
Yuan WANG
1
;
Haiying YANG
;
Dan CHEN
;
Na HUANG
Author Information
1. 仁寿县人民医院呼吸与危重症医学科(四川眉山 620500)
- Publication Type:Journal Article
- Keywords:
Vancomycin;
Therapeutic drug monitoring;
Sepsis;
Prognosis;
Propensity score matched;
MIMIC-Ⅳ database
- From:
Chinese Journal of Pharmacoepidemiology
2025;34(5):500-506
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the relationship between vancomycin therapeutic drug monitoring(TDM)and short-term and long-term prognosis in patients with sepsis.Methods Clinical data of sepsis patients treated in the intensive care unit were obtained from the MIMIC-Ⅳ database.Patients were divided into the TDM group and the non-TDM group based on the status of vancomycin TDM.A 1∶1 propensity score matching(PSM)was employed.The association between vancomycin TDM and the risk of 28 d and 90 d mortality of patients before and after PSM was analyzed using Kaplan-Meier survival curves and multivariate Cox regression models.Meanwhile,the relationship between vancomycin TDM and the risk of mortality within 28 d and 90 d was investigated.Results A total of 3,525 patients were included,with 2,474 in the TDM group and 1,051 in the non-TDM group.After PSM,848 patients were included in each group.The mortality rates at 28 d and 90 d in the TDM group were lower than those in the non-TDM group both before and after PSM(P＜0.005).The Kaplan-Meier curve results showed that the survival rates at 28 d and 90 d in the TDM group were higher than those in the non-TDM group both before and after PSM(P＜0.001).Multivariate COX regression analysis showed that vancomycin TDM was an independent protective factor against mortality risk at 28 d[HR=0.74,95％CI(0.65,0.84),P＜0.001]and 90 d[HR=0.79,95％CI(0.70,0.89),P＜0.001]in sepsis patients.Conclusion Vancomycin TDM reduces the short-term and long-term mortality risk in sepsis patients and is worthy of clinical promotion and application.
