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Published on: September 12, 2016
Development and validation of a nomogram to predict linezolid-induced thrombocytopenia in hospitalized adults
Ya Yang1,2, Xiaogang Hu3, Ya Ran4
1Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Pharmacy, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, No. 20 Jinyu Avenue, Liangjiang New District, Chongqing, 401122, China.
Background:
Linezolid (LZD) is used to treat infectious diseases caused by Gram-positive bacteria, but thrombocytopenia is one of the main adverse reactions to LZD administration. Early prediction of linezolid-induced thrombocytopenia (LI-TP) is of great importance to improve the clinical outcomes and prognoses. The aim of this study was to develop and validate a prediction model for LI-TP.
Methods:
A retrospective cohort of hospitalized adults receiving LZD therapy (January 2014-June 2022) was analyzed. Independent risk factors for LI-TP were identified via logistic regression in the training set (n = 757). A nomogram model for LI-TP were developed based on independent risk factors, and verified in validation set (n = 123).
Results:
The incidence of LI-TP was 13.5% (102/757). A logistic regression model was developed based on the seven independent risk factors, including age (≥ 60 y), duration of LZD therapy (> 11 d), bPLT (< 308 × 109/L), ALT (> 100 IU/L), Ccr (< 67.5 mL/min), and concomitant use with VPA or Tac (p < 0.01) and transformed into a quantifiable nomogram. The nomogram demonstrated strong discrimination with AUCs of 0.760 in training (95% CI: 0.709-0.812, P < 0.001) and 0.767 in validation (95% CI: 0.635-0.899, P < 0.001). The calibration curves and Hosmer-Lemeshow tests confirmed good reliability and specificity of the nomogram model.
Conclusion:
This nomogram provides a practical tool for stratifying LI-TP risk, which provide an important reference for enabling timely clinical interventions to enhance LZD safety.
