Febrile Neutropenia in Post-Chemotherapeutic Patients in Nakhonpathom Hospital
Keywords:
febrile neutropenia, cancer, chemotherapy, hematologic malignancyAbstract
Background: Febrile neutropenia (FN) is a serious and potentially life-threatening condition that may develop in patients with cancer who receive myelosuppressive chemotherapy.
Objectives: To identify the incidence rate, mortality rate, factors associated mortality in FN patients.
Methods: Retrospective study was conducted at Nakhonpathom Hospital during January 1, 2014 and December 31, 2018. Eligible patients were adults, aged >/= 15 years, who had FN due to chemotherapy. Baseline characteristics, site and type of infection were collected. Incidence and mortality of FN were studied. The factors associated mortality outcome were evaluated using multivariate logistic regression analysis.
Results: There were 188 patients and 60% were female. The incidence rate of FN in post-chemotherapeutic patients was 3.5% and mortality rate was 18%. Result of multivariate logistic regression analysis indicated that important factors associated mortality outcome, including more than 4 hours before adequate antibiotic therapy (OR 16.16, 95%CI 3.48-74.99,p < .001), absolute neutrophil count (ANC) less than 100 cells per microliter (OR 3.76, 95%CI 1.26-11.22 p= .018) and ECOG score at least 3 (OR 3.59, 95%CI 1.22-10.58 p= .020). Type of cancer did not influence outcome.
Conclusions: FN in adults results in significant mortality in hospitalized patients. Factors associated with increased mortality include time before adequate antibiotic therapy, ANC and ECOG score.
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