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Background <p>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.</p> Methods <p>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 (<i>n</i> = 757). A nomogram model for LI-TP were developed based on independent risk factors, and verified in validation set (<i>n</i> = 123).</p> Results <p>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 (&gt; 11 d), bPLT (&lt; 308 × 10<sup>9</sup>/L), ALT (&gt; 100 IU/L), Ccr (&lt; 67.5 mL/min), and concomitant use with VPA or Tac (<i>p</i> &lt; 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, <i>P</i> &lt; 0.001) and 0.767 in validation (95% CI: 0.635–0.899, <i>P</i> &lt; 0.001). The calibration curves and Hosmer-Lemeshow tests confirmed good reliability and specificity of the nomogram model.</p> Conclusion <p>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.</p>

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Development and validation of a nomogram to predict linezolid-induced thrombocytopenia in hospitalized adults

  • 期刊论文

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  • 发表日期：

    2025年2月27日

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  • Ya Yang,
  • Xiaogang Hu,
  • Ya Ran,
  • Hongqian Wang,
  • Peishu Fu,
  • Pengpeng Wan,
  • Zhongqing Deng,
  • Xiaoqin Lang,
  • Ning Wang,
  • Fengjun Sun,
  • Yahan Fan,
  • Yuntao Jia

摘要

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.