Abstract
Aim. The study aimed to describe the profile of Filipino febrile neutropenia patients and to determine parameters associated with severe outcomes. Methods. This is a retrospective study of Filipino febrile neutropenia patients admitted to the Philippine General Hospital. Patients were described in terms of clinical presentation and stratified according to the presence or absence of severe outcomes. Prognostic factors were then identified using regression analysis. Results. 115 febrile episodes in 102 patients were identified. Regression analysis yielded prolonged fever >7 days prior to admission (OR 2.43; 95% CI, 0.77–7.74), isolation of a pathogen on cultures (OR 2.69; 95% CI, 1.04–6.98), and nadir absolute neutrophil count (ANC) 7 days prior to admission, positive pathogen on cultures, and nadir ANC < 100 during admission predicted severe outcomes, whereas G-CSF use and complete antibiotic therapy were associated with better outcomes. These prognostic variables might be useful in identifying patients that need more intensive treatment and monitoring.
Highlights
There is a lack of studies on prognostic factors that predict poor outcome in patients with febrile neutropenia
The study aimed to describe the clinical, laboratory, and microbiologic profile of adult Filipino patients with febrile neutropenia, and to determine specific parameters that are potentially associated with severe outcomes, complications, and mortality. This is a retrospective study of adult febrile neutropenia patients admitted at the Philippine General Hospital from January 2010-October 2014
The factors that significantly predicted poor outcome in the univariate analysis were non-treatment/relapse of the underlying disease, prolonged fever >7 days, non-recovery from neutropenia, and severe thrombocytopenia < 50,000/uL complete antibiotic therapy significantly predicted a better outcome Using the factors that reached significance in the univariate analysis, subsequent multivariate analysis showed prolonged fever, positive cultures, and nadir absolute neutrophil count/ANC < 100 during admission as significant predictors of poor outcome
Summary
Predictors of outcome and severity in adult filipino patients with febrile neutropenia. Intr Febrile neutropenia has a significant mortality rate of 5-21.5%, warranting early recognition and appropriate therapy. There is a lack of studies on prognostic factors that predict poor outcome in patients with febrile neutropenia. It is important to identify these factors to recognize patients who will benefit from early aggressive therapy and closer monitoring
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