Objective To analyze the risk factors of tigecycline induced hypofibrinogenemia in elderly patients, and establish a nomogram model of tigecycline-induced hypofibrinogenemia.

Methods Clinical data of elderly patients treated with tigacycline were retrospectively collected from Zhongshan Hospital, Fudan University from January 2022 to December 2023. Patients were divided into hypofibrinogenemia group and non-fibrinogenemia group according to whether they developed hypofibrinogenemia after treatment. Univariate analysis and multivariate Logistic regression analysis were used to analyze the independent risk factors for hypofibrinogenemia in elderly patients during tigecycline application, and a nomogram model was constructed to evaluate the risks of adverse reactions.

Results  A total of 261 elderly patients were included in the study, and 136 (52.1%) had hypofibrinogenemia. The results of univariate analysis showed that weight, days of medication, dosage, baseline fibrinogen, red blood cell count, hemoglobin and combination with glycopeptides were risk factors (P<0.05). Multivariate Logistic regression analysis showed that baseline fibrinogen, days of medication and dosage were all independent risk factors for hypofibrinogenemia in elderly patients (P<0.05). The area under the receiver operating characteristic curve (95%CI) of the nomogram model was 0.774 8 (0.712, 0.827), the sensitivity and specificity were 66.67% and 82.22%, respectively. The average absolute error of calibration curve was 0.039, and the Hosmer-Lemeshow goodness-of-fit test showed that there was no significant difference between the predicted risk value and the measured value.

Conclusion  The baseline fibrinogen, days of medication, dosage are independent risk factors of tigecycline induced hypofibrinogenemia in elderly patients. The nomogram model established on this basis shows good predictive value for assessing the occurrence of adverse reactions.

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