Epidemiology, management and economic impact of febrile neutropenia in oncology patients receiving routine care at a regional UK cancer centre

Abstract

Background: Febrile neutropenia (FN) is a potentially life-threatening complication following chemotherapy. The incidence and mortality of this condition varies according to cancer type and chemotherapy regimen. The aim of the study was to establish the incidence, risk, outcome, infectious cause and economic cost of FN in solid tumour patients within a routine oncology hospital setting.

Patients and methods: All FN solid tumour patients admitted to the oncology unit at a UK regional cancer centre were identified over a 12-month period. Demographic data on age, gender, cancer type, disease burden, chemotherapy regimen, antibiotic treatment, length of hospital stay and outcome was obtained.

Results: The annual incidence of FN was 19.4 per 1000 oncology admissions. The most common patient groups were those with breast (27%), lung (16%), ovarian (13%) and oesophageal (13%) cancers. The mean length of stay was 9.2 days with an average cost of £2353 for an FN episode per patient. The attributable mortality rate was 12.5%. The majority (83%) of patients who died were ≥60 years old, presented with hypotension and had a high-risk FN MASCC index compared with those that survived.

Conclusions: This study demonstrates that FN in solid tumour patients continues to be associated with a significant morbidity and mortality during routine cancer care. Early risk classification of FN may help improve the outcome as well as reduce the economic burden.