Therapeutics and Clinical Risk Management (Apr 2021)
Risk Factors for Tigecycline-Associated Hypofibrinogenemia
Abstract
Jia Liu,1 Yingying Yan,2 Fan Zhang1 1Department of Geriatrics, Peking University Third Hospital, Beijing, People’s Republic of China; 2Department of Pharmacy, Peking University Third Hospital, Beijing, People’s Republic of ChinaCorrespondence: Fan ZhangDepartment of Geriatrics, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, People’s Republic of ChinaTel +86-010-82265685Email [email protected]: 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.Keywords: tigecycline, hypofibrinogenemia, coagulation disorders, risk factors
