预测接受黏菌素治疗患者肾毒性风险模型的验证
Validation of a model to predict the risk of nephrotoxicity in patients receiving colistin.
作者信息
Phe Kady, Johnson Michael L, Palmer Hannah R, Tam Vincent H
机构信息
Department of Pharmacy, Baylor St. Luke's Medical Center, Houston, Texas, USA Department of Clinical Sciences and Administration, University of Houston College of Pharmacy, Houston, Texas, USA.
Department of Clinical Sciences and Administration, University of Houston College of Pharmacy, Houston, Texas, USA.
出版信息
Antimicrob Agents Chemother. 2014 Nov;58(11):6946-8. doi: 10.1128/AAC.03776-14. Epub 2014 Aug 18.
Abstract
Despite concerns about its nephrotoxicity, colistin often remains the only effective agent for treating multidrug-resistant Gram-negative infections. Published studies have reported a wide range of nephrotoxicity risk factors. To assess the clinical utility of various models, we compared their performances for predicting the risk of nephrotoxicity. We identified a model demonstrating reasonable overall risk assessment, with an observed/expected ratio of 1.29 (95% confidence interval [CI], 0.68 to 1.90) and a positive predictive value of 87.5% for identifying patients at high risk of developing nephrotoxicity.
摘要
尽管人们担心黏菌素具有肾毒性，但它通常仍是治疗多重耐药革兰氏阴性菌感染的唯一有效药物。已发表的研究报告了多种肾毒性风险因素。为评估各种模型的临床实用性，我们比较了它们预测肾毒性风险的表现。我们确定了一个显示出合理总体风险评估的模型，其观察值与预期值之比为1.29（95%置信区间[CI]，0.68至1.90），识别发生肾毒性高风险患者的阳性预测值为87.5%。
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