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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Predicting febrile neutropenic patients at low risk using the MASCC score: Does bacteremia matter?
Supportive Care in Cancer, Volume 19, No. 7, Year 2011
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Description
Background Febrile neutropenic cancer patients represent a heterogeneous population with a limited proportion at risk of serious medical complications. The Multinational Association for Supportive Care in Cancer (MASCC) score has been developed and validated for identifying low-risk patients at the onset of febrile neutropenia. Since bacteremia, although not documented at baseline, is a predictor of pejorative outcome, the purpose of this study was to investigate the possible interaction between the MASCC score and bacteremic status and to assess whether, assuming that bacteremic status could be predicted at onset of febrile neutropenia, adding bacteremia as a covariate in a risk model would improve the accuracy of low-risk patients identification. Methods Two consecutive multicentric observational studies were carried out from 1994 till 2005 involving 2,142 febrile neutropenic patients. The study data bases were retrospectively used for the present analysis. Results A predictive value was found for the MASCC score in all strata obtained by stratification for the bacteremic status with odds ratios for successful outcome being, in patients with a score ≥21, respectively, 6.06 (95%CI: 4.51- 8.15), 3.42 (95%CI: 1.95-5.98), and 6.04 (95%CI: 3.01- 12.09) in patients without bacteremia, gram-positive bacteremia, and gram-negative bacteremia. No interaction between the MASCC score and the bacteremic status was present. A clinical prediction rule integrating the MASCC score and the bacteremic status was not helpful in improving the identification of low-risk patients. This rule may then be used in a general population of patients with febrile neutropenia without having concerns for a lower predictive value in bacteremic patients. Conclusions Our results suggest that the knowledge, provided we could find a model to predict it at fever onset, of a bacteremic etiology of the fever would be of little additional value to the MASCC score when attempting to identify low-risk patients. © 2011 Springer-Verlag.
Authors & Co-Authors
Paesmans, Marianne Msc
Belgium, Brussels
Institut Jules Bordet
Klastersky, Jean A.
Belgium, Brussels
Institut Jules Bordet
Maertens, Johan A.
Belgium, Leuven
Ku Leuven– University Hospital Leuven
Georgala, Aspasia
Belgium, Brussels
Cliniques Universitaires Saint-luc
Muanza, Frédérique
Belgium, Brussels
Institut Jules Bordet
Aoun, Mickaël
Belgium, Brussels
Institut Jules Bordet
Ferránt, Augustin E.
Belgium, Brussels
Institut Jules Bordet
Rapoport, Bernardo L.
South Africa, Johannesburg
Medical Oncology Centre of Rosebank
Rolston, Kenneth V.I.
United States, Houston
The University of Texas Md Anderson Cancer Center
Ameye, Lieveke Msc Phd
Belgium, Brussels
Institut Jules Bordet
Statistics
Citations: 40
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1007/s00520-010-0925-7
ISSN:
09414355
e-ISSN:
14337339
Research Areas
Cancer
Study Design
Cross Sectional Study