Analysis on clinical characteristics and risk factors of tigecycline-associated hypofibrinogenemia in critically ill patients
10.3760/cma.j.cn114015-20240126-00067
- VernacularTitle:替加环素相关低纤维蛋白原血症在重症患者中的临床特点及危险因素分析
- Author:
Jin LU
1
;
Guanjun ZHAN
;
Jiabing XU
;
Zhongjing MENG
;
Nini LI
;
Zhongqiu LIU
;
Linlin HU
Author Information
1. 东南大学附属中大医院江北院区药学部，南京 210048
- Publication Type:Journal Article
- Keywords:
Tigecycline;
Intensive care units;
Hypofibrinogenemia;
Risk factors;
Clinical characteristics
- From:
Adverse Drug Reactions Journal
2024;26(10):608-614
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics of tigecycline-associated hypofibrinogenemia in critically ill patients, and analyze risk factors for its occurrence.Methods:Clinical data of patients treated with tigecycline in the Intensive Care Unit (ICU) at Zhongda Hospital Affiliated to Southeast University from January 2021 to December 2022 were collected and retrospectively analyzed. Patients were divided into hypofibrinogenemia group and non-hypofibrinogenemia group according to their fibrinogen levels. General information, laboratory tests results, tigecycline application, combined drugs, and blood concentration of tigecycline were compared between the 2 groups. Variables with P<0.10 in intergroup comparisons were included in a multivariate logistic regression model to analyze the risk factors for tigecycline-associated hypofibrinogenemia, and odds ratios ( OR) and its 95% confidence intervals ( CI) were calculated. Results:A total of 79 patients using tigecycline were collected, including 43 cases with hypofibrinogenemia and 36 cases without hypofibrinogenemia. Univariate analysis showed that the differences in patients with diabetes [41.9%(18/43) vs. 16.7%(6/36)], acute kidney injury [41.9%(18/43) vs. 19.4%(15/36)], and baseline fibrinogen (before tigecycline treatment) ≤4 g/L [37.2%(16/43) vs. 16.7%(6/36)] between the 2 groups were statistically significant (all P<0.05). The related factors ( P<0.10) of the 2 groups, including diabetes, acute renal injury, continuous renal replacement therapy, baseline FIB ≤4 g/L (before using tigecycline), larger total dose of tegacycline and longer treatment duration, were included in the multivariate logistic regression analysis. The results showed that diabetes ( OR=4.851, 95% CI: 1.180-19.494, P=0.029), continuous renal replacement therapy ( OR=8.610, 95% CI: 1.987-37.311, P=0.004), and longer treatment duration ( OR=1.452, 95% CI: 1.018-2.071, P=0.040) were independent risk factors for tigecycline-related hypofibrinogenemia. Conclusion:In critically ill patients, with diabetes, continuous renal replacement therapy, and longer treatment duration of tigecycline may increase the risk of hypofibrinogenemia.
