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Record W2940584139 · doi:10.4212/cjhp.v72i2.2883

Real-Life Frequency of New-Onset Thrombocytopenia during Linezolid Treatment

2019· article· en· W2940584139 on OpenAlexaffvenue
Nicole Giunio-Zorkin, Glen Brown

Bibliographic record

VenueThe Canadian Journal of Hospital Pharmacy · 2019
Typearticle
Languageen
FieldMedicine
TopicAntimicrobial Resistance in Staphylococcus
Canadian institutionsCanadian Journal of Communication (Canada)St. Paul's Hospital
Fundersnot available
KeywordsMedicineLinezolidAdverse effectInternal medicineRetrospective cohort studyConcomitantMedical recordVancomycin

Abstract

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ABSTRACTBackground: Thrombocytopenia is a well-recognized adverse effect of linezolid; however, the frequency of this adverse effect during therapy has been variable across previous studies, and the associated risk factors are unclear. Objectives: To identify the real-life frequency of new-onset thrombo -cytopenia due to linezolid and to determine the associated risk factors. Methods: A retrospective observational cohort study was conducted among consecutive inpatients at a tertiary care hospital who received linezolid for a minimum of 5 days between January 2013 and August 2017. Data were extracted from electronic medical records obtained from a hospital database. Thrombocytopenia was defined as platelet count less than 100 × 109/L or a 50% reduction from baseline (i.e., before linezolid initiation). Risk factors were identified by comparing the characteristics of patients who experienced the adverse effect during linezolid therapy with those of patients who did not experience the adverse effect. Continuous data were analyzed with the t test and categorical data with the 2 test. Results: A total of 102 patients were included (38 women, 64 men; overall mean age 50 years, standard deviation [SD] 21). The mean duration of linezolid therapy was 14 (SD 10) days. Thrombocytopenia occurred in 18 patients (17.6%). Risk factors for the development of thrombocytopenia included mean duration of therapy (22 [SD 18] days versus 12 [SD 7] days; p = 0.023), renal replacement therapy (17% versus 4%; p = 0.032), renal impairment (61% versus 32%; p = 0.021), and concomitant administration of unfractionated heparin (50% versus 21%; p = 0.013). Conclusions: The real-life frequency of new-onset of thrombocytopenia in patients receiving linezolid for a minimum of 5 days was 17.6%. Risk factors for linezolid-induced thrombocytopenia included prolonged duration of therapy, renal impairment, and concomitant unfractionated heparin.RÉSUMÉContexte : La thrombopénie est une réaction indésirable bien connue, induite par le linézolide; cependant, la fréquence de cette réaction indésirable pendant le traitement hvariait d’une étude à l’autre et on ignore quels sont les facteurs de risque associés à cet antibiotique. Objectifs : Découvrir la fréquence réelle des nouveaux cas de thrombopénie causés par le linézolide et déterminer les facteurs de risque qui lui sont associés. Méthodes : Une étude de cohorte observationnelle rétrospective a été menée auprès de patients hospitalisés consécutivement dans un hôpital de soins tertiaires, qui ont reçu du linézolide pendant au moins cinq jours entre janvier 2013 et août 2017. Les données ont été tirées des dossiers médicaux électroniques provenant d’une base de données d’un hôpital. La thrombopénie a été définie comme un taux de plaquettes de moins de 100 × 109/L ou comme une réduction de 50 % de leur valeur initiale (c’est-à-dire, avant l’amorce du traitement au linézolide). Les chercheurs ont établi les facteurs de risque en comparant les caractéristiques des patients ayant subi la réaction indésirable pendant leur traitement au linézolide avec les caractéristiques des patients n’ayant pas subi cet effet indésirable. Les données continues ont été analysées à l’aide d’un test t et les données catégoriques à l’aide d’un test de 2. Résultats : Au total, 102 patients ont été admis (38 femmes, 64 hommes; âge moyen de 50 ans, écart-type de 21). La durée du traitement au linézolide était de 14 jours (écart-type de 10). Dix-huit patients (17,6 %) ont souffert de thrombopénie. Parmi les facteurs de risque de thrombopénie, on comptait la durée moyenne du traitement (22 jours [écart-type de 18] contre 12 jours [écart-type de 7]; p = 0,023), le traitement de suppléance rénale (17 % contre 4 %; p = 0,032), l’insuffisance rénale (61 % contre 32 %; p = 0,021) et l’administration concomitante d’héparine non fractionnée (50 % contre 21 %; p = 0,013). Conclusions : La fréquence réelle de nouveaux cas de thrombopénie parmi les patients recevant du linézolide pendant un minimum de 5 jours était de 17,6 %. Parmi les facteurs de risque de thrombopénie associés au linézolide, on mentionne l’allongement de la durée du traitement, l’insuffisance rénale et l’administration concomitante d’héparine non fractionnée.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.049
Threshold uncertainty score0.961

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.023
GPT teacher head0.300
Teacher spread0.277 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations28
Published2019
Admission routes2
Has abstractyes

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