Retrospective cohort study on the correlation between hypoalbuminemia and caspofungin-induced liver injury
10.3760/cma.j.cn114015-20221123-01086
- VernacularTitle:低白蛋白血症与卡泊芬净导致肝损伤相关性的回顾性队列研究
- Author:
Fan CHEN
1
;
Jianmin LIU
;
Shuli HU
;
Shaohui ZHANG
Author Information
1. 武汉市第一医院药学部，武汉 430022
- Publication Type:Journal Article
- Keywords:
Caspofungin;
Chemical and drug induced liver injury;
Hypoalbuminemia;
Retrospective studies
- From:
Adverse Drug Reactions Journal
2023;25(7):419-423
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the correlation between hypoalbuminemia and caspofungin-induced liver injury.Methods:This research was designed as a retrospective cohort study. The medical records of discharged adult patients treated with caspofungin acetate for injection (caspofungin) in Wuhan No.1 Hospital from January 1, 2019 to December 31, 2021 were extracted through the electronic medical record system. According to the average serum albumin level during caspofungin treatment, patients were divided into hypoalbuminemia group and non-hypoalbuminemia group. Propensity score matching (PSM) was performed for gender, age, weight, underlying disease, and hospital stay, etc. in a 1∶1 ratio in patients between hypoalbuminemia and non-hypoalbuminemia groups. Taking the occurrence of drug-induced liver injury as the outcome index, the incidences of liver injury were compared between the 2 groups, before and after PSM. The relative risk ( RR) and its 95% confidence interval ( CI) of caspofungin-related liver injury were calculated by cluster study method. Results:A total of 357 patients were entered, including 202 (56.6%) males and 155 (43.4%) females; 72 patients (20.2%) were in the hypoalbuminemia group and 285 patients (79.8%) were in the non-hypoalbuminemia group. Twenty-eight patients (7.8%) were judged with caspofungin-related liver injury, including 21 in the hypoalbuminemia group and 7 in the non-hypoalbuminemia group. The difference in the incidence of liver injury between the 2 groups was statistically significant whether before or after PSM [29.2% (21/72) vs. 2.5% (7/285), P<0.001; 29.2% (21/72) vs. 2.8% (2/72), P<0.001]. The results of the cluster study after PSM showed that hypoalbuminemia had a strong positive correlation with caspofungin-related liver injury ( RR=10.500, 95% CI: 2.555-43.143), and the incidence of caspofungin-related liver injury in patients with hypoalbuminemia was 26.39% higher than that in patients without hypoalbuminemia. Conclusion:Hypoalbuminemia was significantly correlated to the occurrence of caspofungin-related liver injury.
