Predictive value of augmented renal clearance on the therapeutic efficacy of cefoperazone sodium/sulbactam sodium injections in elderly patients in intensive care unit

doi:10.3969/j.issn.1004-583X.2023.04.008

Abstract

Abstract:

Objective To explore the predictive value of augmented renal clearance (ARC) on the therapeutic efficacy of cefoperazone sodium/sulbactam sodium injections in elderly patients in intensive care unit (ICU), thus providing theoretical reference for clinical diagnosis and treatment. Methods A total of 528 elderly patients admitted to the Intensive Care Department of Linyi People's Hospital from January 2020 to December 2021 were selected and allocated to ARC group (n=106) and non-ARC group (n=422) based on the occurrence of ARC. Baseline characteristics, deep steady-state trough concentration of cefoperazone sodium/sulbactam sodium (measured the efficacy of cefoperazone sodium/sulbactam sodium on half an hour before the medication) were collected and compared. Univariable and multivariable logistic regression analyses were performed to identify risk factors for the therapeutic efficacy of cefoperazone sodium/sulbactam sodium on elderly patients in ICU, and the predictive value on the efficacy was assessed by plotting the receiver operating characteristic curve. Results The incidence of ARC in this study was 20.1%. There were no significant differences in sex, body mass index (BMI), total protein, albumin, globulin, albumin/globulin ratio, alanine aminotransferase, total bilirubin, and uric acid between the two groups (P>0.05). Compared with those of the non-ARC group, patients in the ARC group were significantly younger with significantly lower blood urea nitrogen and creatinine, and higher creatinine clearance rate (CCr) and glomerular filtration rate (GFR)(P<0.05). There were significant differences in the deep steady-state trough concentration of cefoperazone sodium/sulbactam sodium and clinical outcomes between groups (P<0.05). Compared with those of the non-ARC group, patients in the ARC group had a significantly longer length of stay and higher mortality (P<0.05). Multivariate logistic regression analysis showed that ARC, age, blood urea nitrogen, creatinine, CCr, and GFR were all independent risk factors for the efficacy of cefoperazone sodium/sulbactam sodium injections on elderly patients in ICU (P<0.05). The receiver characteristic curve showed that the area under the curve of ARC predicting the efficacy of cefoperazone sodium/sulbactam sodium injections in elderly ICU patients was 0.828, with a sensitivity of 89.69% and a specificity of 78.28%.Conclusion ARC has a good predictive value for the efficacy of cefoperazone sodium/sulbactam sodium injections on elderly patients in ICU.

Key words: augmented renal clearance, intensive care unit, the elderly, cefoperazone sodium/sulbactam sodium injections

CLC Number:

R197.3

Wang Youfang, Li Xingchao, Zhu Xiaosong, Zhou Tingfa, Zhang Jianguo, Yang Shuhong, Xiang Ran, Zhang Mengmeng, Che Fengyuan. Predictive value of augmented renal clearance on the therapeutic efficacy of cefoperazone sodium/sulbactam sodium injections in elderly patients in intensive care unit[J]. Clinical Focus, 2023, 38(4): 335-339.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.04.008

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I4/335

Figures/Tables 7

References 22

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组别	例数	性别[例(%)]			年龄 (岁)	体质量指数 (kg/m²)	总蛋白 (g/L)		白蛋白 (g/L)		球蛋白 (g/L)		白球比
组别	例数	男		女	年龄 (岁)	体质量指数 (kg/m²)	总蛋白 (g/L)		白蛋白 (g/L)		球蛋白 (g/L)		白球比
ARC组	106	61(57.6)		45(42.4)	66.28±5.36	25.82±3.63	72.12±8.61		41.25±6.56		33.16±4.31		1.18±0.22
非ARC组	422	253(60.0)		169(40.0)	75.12±7.96	23.25±4.11	70.57±7.12		38.82±6.81		32.20±3.68		1.15±0.19
统计值		χ²=0.935			F=4.682	F=0.381	F=0.216		F=0.462		F=0.245		F=0.269
P值		0.685			0.008	0.677	0.821		0.556		0.782		0.806
组别	谷丙转氨酶 (U/L)		总胆红素 (μmol/L)		尿素氮 (mmol/L)	肌酐 (μmol/L)		尿酸 (μmol/L)		CCr (ml/min)		GFR [ml/(min·1.73 m²)]
ARC组	40.68±7.17		15.81±6.46		5.36±1.63	45.33±12.09		207.36±31.73		151.20±17.86		147.86±30.72
非ARC组	36.31±9.69		17.18±5.21		6.88±1.54	77.25±18.12		218.14±28.36		87.12±19.11		79.51±18.36
统计值	F=0.318		F=0.541		F=5.565	F=16.221		F=1.445		F=38.306		F=33.682
P值	0.628		0.533		0.001	0.000		0.365		0.000		0.000

组别	例数	性别[例(%)]			年龄 (岁)	体质量指数 (kg/m²)	总蛋白 (g/L)		白蛋白 (g/L)		球蛋白 (g/L)		白球比
组别	例数	男		女	年龄 (岁)	体质量指数 (kg/m²)	总蛋白 (g/L)		白蛋白 (g/L)		球蛋白 (g/L)		白球比
ARC组	106	61(57.6)		45(42.4)	66.28±5.36	25.82±3.63	72.12±8.61		41.25±6.56		33.16±4.31		1.18±0.22
非ARC组	422	253(60.0)		169(40.0)	75.12±7.96	23.25±4.11	70.57±7.12		38.82±6.81		32.20±3.68		1.15±0.19
统计值		χ²=0.935			F=4.682	F=0.381	F=0.216		F=0.462		F=0.245		F=0.269
P值		0.685			0.008	0.677	0.821		0.556		0.782		0.806
组别	谷丙转氨酶 (U/L)		总胆红素 (μmol/L)		尿素氮 (mmol/L)	肌酐 (μmol/L)		尿酸 (μmol/L)		CCr (ml/min)		GFR [ml/(min·1.73 m²)]
ARC组	40.68±7.17		15.81±6.46		5.36±1.63	45.33±12.09		207.36±31.73		151.20±17.86		147.86±30.72
非ARC组	36.31±9.69		17.18±5.21		6.88±1.54	77.25±18.12		218.14±28.36		87.12±19.11		79.51±18.36
统计值	F=0.318		F=0.541		F=5.565	F=16.221		F=1.445		F=38.306		F=33.682
P值	0.628		0.533		0.001	0.000		0.365		0.000		0.000

组别	例数	<10 μmol/ml	10~15 μmol/ml	>15~20 μmol/ml	>20 μmol/ml
ARC组	106	86(81.1)	11(10.4)	8(7.6)	1(1.0)
非ARC组	422	117(27.7)	122(28.9)	68(16.1)	115(27.3)
χ²值		16.228	7.861	9.117	14.469
P值		0.000	0.000	0.000	0.000

组别	例数	<10 μmol/ml	10~15 μmol/ml	>15~20 μmol/ml	>20 μmol/ml
ARC组	106	86(81.1)	11(10.4)	8(7.6)	1(1.0)
非ARC组	422	117(27.7)	122(28.9)	68(16.1)	115(27.3)
χ²值		16.228	7.861	9.117	14.469
P值		0.000	0.000	0.000	0.000

组别	例数	住院时间(天)	临床结局[例(%)]			死亡人数 [例(%)]
组别	例数	住院时间(天)	有效	好转	无效	死亡人数 [例(%)]
ARC组	106	8.71±3.63	43(40.6)	36(34.0)	27(25.4)	5(4.7)
非ARC组	422	5.65±2.28	195(46.2)	186(44.1)	41(9.7)	8(1.9)
统计值		F=4.122	χ²=8.315			χ²=6.802
P值		0.000	0.000			0.000