A proposed score for predicting severe infection complications in children with chemotherapy-induced febrile neutropenia

A proposed score for predicting severe infection complications in children with chemotherapy-induced febrile neutropenia

Author Porto Rondinelli, Patricia Imperatriz Google Scholar
Braga Ribeiro, Karina de Cassia Google Scholar
Camargo, Beatriz de Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Hosp Canc AC Camargo
Abstract Background: Febrile neutropenia (FN) is one of most common complications in patients with cancer during chemotherapy. Identifying factors associated with severe infectious complications (SICs) at time of admission for fever and neutropenia is necessary for better treatment.Procedure: We revised all medical charts of patients under 18 years old who developed a first episode of FN present from January 2000 to December 2003. Criteria for a SIC were defined. These included the presence of bacteremia or fungemia, sepsis, septic shock, and/or death from infection. To identify risk factors SIC was associated with the first FN episode.Results: Factors identified in univariate analysis were female sex, age less than 5 years old, acute myeloid leukemia, baseline disease activity, use of central venous catheter, hemoglobin level < 7 g/dL, leukocytes count < 500cellS/mm(3), granulocytes count < 500 cells/mm(3), monocytes count < 100 cells/mm(3), platelets < 20,000, and body temperature > 38.5 degrees C, a chemotherapy interval < 7 days, presence of mucositis, pneumonia, absence of upper respiratory tract infection, or the presence of any clinical focus on first physical examination. in multivariate analysis the variables that remained as independent predictive risk factors for SIC were age less than 5 years, use of central venous catheter, body temperature > 38.5 degrees C, hemoglobin level < 7 g/dL, any clinical focus of infection on first examination and absence of upper respiratory tract infection. the FN population was than divided among 3 different risk groups as follows: group I (low risk), group 2 (intermediate risk), with a 13 (4.4 to 38.3)-fold risk for SIC; and group 3 (high risk) with a 50 (16.4 to 149.2)-fold risk for SIC.Conclusions: This study suggests that patients with FN can be stratified for risk of SIC using clinical parameters at hospital admission.
Keywords infection
febrile neutropenia
children with cancer
severe infection complications
Language English
Date 2006-10-01
Published in Journal of Pediatric Hematology Oncology. Philadelphia: Lippincott Williams & Wilkins, v. 28, n. 10, p. 665-670, 2006.
ISSN 1077-4114 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 665-670
Origin http://dx.doi.org/10.1097/01.mph.0000212996.94929.0b
Access rights Closed access
Type Article
Web of Science ID WOS:000242395600006
URI http://repositorio.unifesp.br/handle/11600/29198

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