A multicenter prospective study of 515 febrile neutropenia episodes in Argentina during a 5-year period

Abstract

For better management of patients with febrile neutropenia, our study investigated the epidemiologic, microbiologic, and clinical characteristics of adult inpatients with febrile neutropenia and their mortality-associated factors. To this end, we carried out a prospective, observational, multicenter study in 28 Argentinian hospitals between 2007 and 2012. We included 515 episodes of febrile neutropenia from 346 patients, median age 49 years. Neutropenia followed chemotherapy in 77% of cases, half of the cases due to hematological malignancies. Most episodes were classified as high-risk according to MASCC criteria, and 53.6% of patients were already hospitalized at the onset of febrile neutropenia. Bloodstream infections were detected in 14% episodes; whereas an infectious source of fever was identified in 80% of cases. Mortality rate achieved to 14.95%. The binary regression analysis showed that persistence of fever at day 7, or neutropenia at day 14, dehydration and tachycardia at the onset of febrile neutropenia as well as prior infections were significantly associated with mortality. In addition to expanding our current knowledge on the features of adult patients with febrile neutropenia, present findings provide useful information for better management of them in Argentina, given the appropriate representativeness of centers participating in the study.

Epidemiology and source of infection in cancer patients with febrile neutropenia: an experience from a developing country

“…Even though Staphylococcus species were cited as the most prevalent gram-positive pathogen in earlier studies [ 32 ], the most common gram-positive pathogen in this study was E. fecalis . Guidelines for the empirical treatment of FN emphasize the need of P. aeruginosa and MRSA coverage.…”

Clinical factors predictive of recurrent febrile neutropenia in adult patients with acute leukemia

“…Regarding clinical outcomes between the recurrent and non-recurrent FN groups in acute leukemia, most of them in this study were comparable except for the proportions of septic shock, bloodstream infection, and E. faecalis infection ( Table 3 ). As previously reported, both septic shock and bloodstream infection increased the risk of mortality[ 2 , 14 , 15 ]. The mortality group had a significantly higher proportion of septic shock than those who survived (86.4% vs 13.6%; p < 0.001) [2] .…”

Remote Monitoring of Patients With Hematologic Malignancies at High Risk of Febrile Neutropenia: Exploratory Study

“…As a population, less than 40% of patients with an FNE may demonstrate concurrent tachycardia [18]. Within this cohort specifically, only 12 of the 17 true FNEs were associated with a heart rate >100 bpm.…”

“…However, tachycardia associated with the FNE represented a high-risk feature, indicating possible clinical decline. In fact, in a multicenter prospective study of 346 patients with 515 FNEs, tachycardia at presentation was one of the strongest predictors of mortality [18]. The association was higher than all other abnormalities in vital signs, including tachypnea and hypotension, as well as many other known risk factors such as previous invasive fungal infections, oliguria, or initial positive blood cultures.…”