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. 2021 Jul;29(7):4089-4094.
doi: 10.1007/s00520-020-05924-w. Epub 2021 Jan 6.

Determination of the relationship between mortality and SOFA, qSOFA, MASCC scores in febrile neutropenic patients monitored in the intensive care unit

Tugba Cetintepe  1 , Lutfi Cetintepe  2 , Serife Solmaz  3 , Sebnem Calık  4 , Mehmet Can Ugur  5 , Fusun Gediz  5 , Oktay Bilgir  5
Affiliations

Determination of the relationship between mortality and SOFA, qSOFA, MASCC scores in febrile neutropenic patients monitored in the intensive care unit

Tugba Cetintepe et al. Support Care Cancer. 2021 Jul.

Abstract

Purpose: Febrile neutropenia (FN) is a hematological emergency. It is challenging and confusing for the clinicians to make the decision of the febrile neutropenic patients under chemotherapy to be monitored at intensive care unit (ICU). The aim of this study was to define the factors supporting decision-making for the critical patients with febrile neutropenia.

Methods: The data of 60 patients, who were taken to the ICU while they were under treatment in the Hematology Clinic with a diagnosis of febrile neutropenia, were analyzed retrospectively, in order to identify clinically useful prognostic parameters.

Results: The ICU mortality rate was 80%. Mortality was significantly associated with higher sequential organ failure assessment score (SOFA), quick sequential organ failure assessment score (qSOFA), and hematological SOFA (SOFAhem) scores on admission. All cases having SOFA score 10 and above and qSOFA score 2 and above died. In multivariate analysis, qSOFA score was found to be statistically significant in predicting mortality in regard to ICU admission (p = 0.004).

Conclusion: Mortality of febrile neutropenic patients admitted to ICU is high. It would be appropriate to determine the extent of organ dysfunction instead of underlying disease, for making the decision of ICU admission. It should be noticed that the risk mortality is high for the FN cases with SOFA score 10 or above, qSOFA score 2 or above, and in need of mechanical ventilation and positive inotropic support; hence, early intervention is recommended. In our study, the most significant parameter in predicting ICU mortality was found to be qSOFA.

Keywords: Febrile neutropenia; Hematological malignancy; Intensive care unit; SOFA score; qSOFA score.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

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