Objective  To explore the influencing factors of abnormal liver function induced by enoxaparin sodium and construct a Logistic risk prediction model.

Methods  Clinical data of patients from Xixi Hospital of Hangzhou receiving enoxaparin sodium anticoagulation therapy from February 2023 to June 2024 were retrospectively analyzed. According to whether abnormal liver function occurred, the patients were divided into abnormal liver function group and non-abnormal liver function group. Colinearity diagnostic analysis and multivariate Logistic regression model analysis were adopted to analyze the risk factors of enoxaparin sodium-induced abnormal liver function, and a risk prediction model was constructed. Predictive efficiency of the model was evaluated by receiver operation characteristic (ROC) curve, and decision curve analysis (DCA) was applied to assess the clinical practical value of the model.

Results  A total of 218 patients were enrolled in the study, including 21 cases (9.63%) with abnormal liver function. Univariate analysis suggested that the proportion of age≥65 years old, body mass index (BMI), proportion of chronic kidney disease, proportion of types of combined drugs≥3, baseline anti-Xa activity and cumulative dose of enoxaparin sodium in abnormal liver function group were significantly higher compared to non-abnormal liver function group (P<0.05). Colinearity diagnostic analysis and multivariate Logistic regression model analysis revealed that high BMI, comorbid chronic kidney disease and high cumulative dose of enoxaparin sodium were independent risk factors of enoxaparin sodium-induced abnormal liver function (P<0.05). Logistic regression model was constructed based on the above factors, and ROC curve analysis demonstrated that the area under the curve (AUC), sensitivity and specificity of the model were 0.98, 95.24% and 94.42%, respectively. DCA analysis suggested that when the threshold probability was 2%-87%, the model had a higher clinical net income.

Conclusion Patients with high BMI, chronic kidney disease and high cumulative dose of enoxaparin sodium are more likely to develop enoxaparin sodium-induced abnormal liver function.

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