Development and Validation of a Risk Prediction Model of Vancomycin‐Associated Nephrotoxicity in Elderly Patients: A Pilot Study
Development and Validation of a Risk Prediction Model of Vancomycin‐Associated Nephrotoxicity in Elderly Patients: A Pilot Study
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DOI：
10.1111/cts.12731
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发表时间：
2019-11
期刊：
影响因子：
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通讯作者：
Chen Pan;A. Wen;Xingang Li;Dandan Li;Yang-Yang Zhang-Yang;Y. Liao;Yue Ren;S. Shen
中科院分区：
文献类型：
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作者：
Chen Pan;A. Wen;Xingang Li;Dandan Li;Yang-Yang Zhang-Yang;Y. Liao;Yue Ren;S. Shen
本探索性研究旨在建立老年患者万古霉素相关性肾毒性(VANT)风险预测模型。检索2016年1月至2018年6月接受万古霉素治疗的老年患者的临床资料。这项研究共纳入255名患者。单因素分析和多因素Logistic回归分析显示，万古霉素谷值≥20 mg/L(优势比(OR)=3.009；95%可信区间(CI)1.345~6.732)、手术(OR=3.357；95%CI 1.309~8.605)、Charlson合并症指数≥4分(OR=2.604；95%CI 1.172~5.787)、同时使用强心药物(OR=3.283；95%CI 1.340~8.042)、血浆容量扩张器(OR=3.459)；95%可信区间1.428~8.382)和哌拉西林/他唑巴坦比值(OR=2.547；95%可信区间1.680~6.007)是老年VANT的危险因素。在此基础上，建立了VANT风险预测模型，该模型具有较好的判别能力和良好的定标能力。
This exploratory study aimed to develop a risk prediction model of vancomycin‐associated nephrotoxicity (VANT) in elderly patients. Clinical information of elderly patients who received vancomycin therapy from January 2016 to June 2018 was retrieved. A total of 255 patients were included in this study. Univariate analysis and multivariable logistic regression analysis revealed that vancomycin trough concentration ≥ 20 mg/L (odds ratio (OR) = 3.009; 95% confidence interval (CI) 1.345–6.732), surgery (OR = 3.357; 95% CI 1.309–8.605), the Charlson Comorbidities Index ≥ 4 points (OR = 2.604; 95% CI 1.172–5.787), concomitant use of cardiotonic drug (OR = 3.283; 95% CI 1.340–8.042), plasma volume expander (OR = 3.459; 95% CI 1.428–8.382), and piperacillin/tazobactam (OR = 2.547; 95% CI 1.680–6.007) were risk factors for VANT in elderly patients. Furthermore, a VANT risk prediction model was developed, which had good discriminative power and was well‐calibrated.