Retrospective study on the correlation between MASCC score and the evolution of febrile neutropenia for patients with solid cancer.

Abstract

e13570 Retrospective study on the correlation between MASCC score and the evolution of febrile neutropenia for patients with solid cancer. Background: The Multinational Association for Supportive Care in Cancer (MASCC) score is used to risk-stratify outpatients with febrile neutropenia. Currently, data on the use of the MASCC score are based on studies with a small number of patients. Our primary aim was to determine whether a MASCC score ≥ 21 identifies patients with solid tumors who would evolve without complications. Methods: We conducted a retrospective cohort study of patients admitted with febrile neutropenia and solid cancer at Sherbrooke University Hospital from 2011 to 2022. We collected patients' demographics, type of cancer, current chemotherapy regimen, whether patients were candidates for outpatient treatment, MASCC score, duration of IV antibiotic therapy, complications (intensive care unit admission, hypotension, hypoxemia, acute kidney failure, bacteriemia (persistent or developing after 48h of IV antibiotics) and escalation in antimicrobial regimen after hospital admission), and inpatient deaths. We used chi-square analysis and multivariate analysis to determine factors other than MASCC that predict complications. Results: A total of 290 febrile neutropenia patients with solid tumors were identified. 93 patients had a MASCC score <21 and 196 were identified as low risk (MASCC score ≥ 21). The preliminary results showed that the MASCC score had a specificity of 58,3% [95% CI 48,4%-67,8%], a sensibility of 83,0% [95% CI 76,7%-88,1%], a positive predictive value of 77,0% [95% CI 72,7%-80,9%] and a negative predictive value of 67,0 [95% CI 58,7%-74,4%] to identify complications. A low risk MASCC score showed statistically significative reduction in duration of neutropenia, IV antibiotics, fever and length of hospitalisation. Conclusions: The MASCC score did not demonstrate high enough accuracy to precisely identify patients which would have evolved without complications. However, a low-risk score identified by using the MASCC score was found to have strong association with reduction of duration of hospitalisation burden. Furter data will be collected to increase the strength of the study.