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Risk Factors for Tigecycline-Associated Hypofibrinogenemia

BACKGROUND: With the widespread use of tigecycline, especially in elderly people infected with multidrug-resistant bacteria, the associated coagulation disorders are attracting the attention of clinicians. The risk factors of tigecycline-associated hypofibrinogenemia are still controversial. PURPOSE...

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Autores principales: Liu, Jia, Yan, Yingying, Zhang, Fan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057826/
https://www.ncbi.nlm.nih.gov/pubmed/33888987
http://dx.doi.org/10.2147/TCRM.S302850
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author Liu, Jia
Yan, Yingying
Zhang, Fan
author_facet Liu, Jia
Yan, Yingying
Zhang, Fan
author_sort Liu, Jia
collection PubMed
description BACKGROUND: With the widespread use of tigecycline, especially in elderly people infected with multidrug-resistant bacteria, the associated coagulation disorders are attracting the attention of clinicians. The risk factors of tigecycline-associated hypofibrinogenemia are still controversial. PURPOSE: The aims of our study were to explore the related factors of hypofibrinogenemia caused by tigecycline, and to establish the risk assessment criteria for tigecycline-associated hypofibrinogenemia. PATIENTS AND METHODS: This was an observational retrospective cohort study of patients treated for at least 3 days with tigecycline. Hypofibrinogenemia was defined as plasma fibrinogen <2.0 g/L. Risk factors were determined using logistic regression analysis, and the risk assessment criteria were identified by using receiver operating characteristic curves. RESULTS: In total, 148 patients were included in the analysis, mean age was 77.09±15.11 years old. Ninety patients who developed hypofibrinogenemia during tigecycline treatment with mean plasma fibrinogen of 1.42 g/L were included in the hypofibrinogenemia group, the other 58 patients with mean plasma fibrinogen of 2.68 g/L were included in the normal group. In the multivariate analysis, age (p = 0.035), tigecycline treatment duration (p = 0.044), and baseline fibrinogen level (p = 0.002) were independently associated with hypofibrinogenemia. An age of ≥82 years, ≥9 days of medication, and a baseline fibrinogen level of ≤3.5 g/L were selected for predicting hypofibrinogenemia. Hypofibrinogenemia was independently associated with bleeding (OR 8.96, 95% CI [1.132–70.946], p = 0.038). CONCLUSION: Hypofibrinogenemia is a common adverse effect of tigecycline in our study. Elderly patients are more prone to developing hypofibrinogenemia after the administration of tigecycline. It is independently associated with bleeding but not death. The risk assessment criteria can help in the identification of patients with high risk of hypofibrinogenemia.
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spelling pubmed-80578262021-04-21 Risk Factors for Tigecycline-Associated Hypofibrinogenemia Liu, Jia Yan, Yingying Zhang, Fan Ther Clin Risk Manag Original Research BACKGROUND: With the widespread use of tigecycline, especially in elderly people infected with multidrug-resistant bacteria, the associated coagulation disorders are attracting the attention of clinicians. The risk factors of tigecycline-associated hypofibrinogenemia are still controversial. PURPOSE: The aims of our study were to explore the related factors of hypofibrinogenemia caused by tigecycline, and to establish the risk assessment criteria for tigecycline-associated hypofibrinogenemia. PATIENTS AND METHODS: This was an observational retrospective cohort study of patients treated for at least 3 days with tigecycline. Hypofibrinogenemia was defined as plasma fibrinogen <2.0 g/L. Risk factors were determined using logistic regression analysis, and the risk assessment criteria were identified by using receiver operating characteristic curves. RESULTS: In total, 148 patients were included in the analysis, mean age was 77.09±15.11 years old. Ninety patients who developed hypofibrinogenemia during tigecycline treatment with mean plasma fibrinogen of 1.42 g/L were included in the hypofibrinogenemia group, the other 58 patients with mean plasma fibrinogen of 2.68 g/L were included in the normal group. In the multivariate analysis, age (p = 0.035), tigecycline treatment duration (p = 0.044), and baseline fibrinogen level (p = 0.002) were independently associated with hypofibrinogenemia. An age of ≥82 years, ≥9 days of medication, and a baseline fibrinogen level of ≤3.5 g/L were selected for predicting hypofibrinogenemia. Hypofibrinogenemia was independently associated with bleeding (OR 8.96, 95% CI [1.132–70.946], p = 0.038). CONCLUSION: Hypofibrinogenemia is a common adverse effect of tigecycline in our study. Elderly patients are more prone to developing hypofibrinogenemia after the administration of tigecycline. It is independently associated with bleeding but not death. The risk assessment criteria can help in the identification of patients with high risk of hypofibrinogenemia. Dove 2021-04-16 /pmc/articles/PMC8057826/ /pubmed/33888987 http://dx.doi.org/10.2147/TCRM.S302850 Text en © 2021 Liu et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Liu, Jia
Yan, Yingying
Zhang, Fan
Risk Factors for Tigecycline-Associated Hypofibrinogenemia
title Risk Factors for Tigecycline-Associated Hypofibrinogenemia
title_full Risk Factors for Tigecycline-Associated Hypofibrinogenemia
title_fullStr Risk Factors for Tigecycline-Associated Hypofibrinogenemia
title_full_unstemmed Risk Factors for Tigecycline-Associated Hypofibrinogenemia
title_short Risk Factors for Tigecycline-Associated Hypofibrinogenemia
title_sort risk factors for tigecycline-associated hypofibrinogenemia
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057826/
https://www.ncbi.nlm.nih.gov/pubmed/33888987
http://dx.doi.org/10.2147/TCRM.S302850
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