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Analysis of influencing factors and prediction models of vancomycin AUC0-24 h in postoperative orthopedic patients

Published on Feb. 08, 2024Total Views: 720 times Total Downloads: 381 times Download Mobile

Author: YANG Hao 1, 2 XIONG Xiong 3 LIU Changjiang 1, 2 JIN Xiaoyue 1, 2

Affiliation: 1. Department of Pharmacy, The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830001, China 2. Department of Pharmacy, The Sixth Clinical College of Xinjiang Medical University, Urumqi 830001, China 3. School of Pharmacy, Xinjiang Medical University, Urumqi 830017, China

Keywords: Postoperative orthopedic surgery Vancomycin Area under curve for 24  h Predictive modeling

DOI: 10.12173/j.issn.1008-049X.202311261

Reference: YANG Hao, XIONG Xiong, LIU Changjiang, JIN Xiaoyue.Analysis of influencing factors and prediction models of vancomycin AUC0-24 hin postoperative orthopedic patients[J].Zhongguo Yaoshi Zazhi,2024, 27(1):66-75.DOI: 10.12173/j.issn.1008-049X.202311261.[Article in Chinese]

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Abstract

Objective  To investigate the influencing factors of vancomycin in the area under curve for 24 h (AUC0-24 h) in patients after orthopedic surgery, and to predictive and analyze a good pharmacokinetic model for AUC0-24 h.

Methods  Patients who underwent orthopedic surgery and used vancomycin in The Sixth Affiliated Hospital of Xinjiang Medical University from January 2018 to December 2022 were included, and the basic information, the medication, the blood and biochemical indexes of the patients were collected to analyze the factors affecting postoperative vancomycin AUC0-24 h in orthopedic surgery. The AUC0- 24 h was calculated using the first-level pharmacokinetic formula, the JavaPK® for Desktop (JPKD) and the vancomycin daily dose elimination rate formula.

Results  91 patients were finally included, and the cystatin C (OR=189.168, P=0.005) and the single dose (OR=19.160, P<0.001) were independent protective factors for vancomycin AUC0-24 h in postoperative orthopedic patients, and the retinol binding protein was an independent risk factor for vancomycin AUC0-24 h (OR=0.910, P<0.05). By predicting and analyzing the model of vancomycin AUC0-24 h in postoperative orthopedic patients, the absolute percentage error of both JPKD software and vancomycin daily dose elimination rate formula were lower than 30%. The intraclass correlation efficient between the AUC0-24 h of the JPKD software and vancomycin daily dose elimination rate formula, and the AUC0-24 h of the first-level pharmacokinetic formula were 0.781 and 0.524, respectively.

Conclusion  Cystatin C is an important factor influencing vancomycin AUC0- 24 h in postoperative orthopedic patients, and JPKD software is more suitable for predicting vancomycin AUC0-24 h after orthopedic surgery than the vancomycin daily dose elimination rate formula method.

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