Usefulness analysis of the 2018 ASCO/IDSA guideline for outpatient management of fever and neutropenia in adults treated for malignancy.
Soyoon HwangKi Tae KwonYoonjung KimSohyun BaeHyun-Ha ChangShin-Woo KimSeung Soo YooSu Youn NamJin Ho BaekPublished in: Scientific reports (2021)
Although the clinical practice guideline for outpatient management of febrile neutropenia (FN) in adults treated for malignancy was updated by the ASCO/IDSA in 2018, most patients with FN in our hospital have been hospitalized. We performed this study to analyze the usefulness of the guideline. The medical records of patients hospitalized for FN in Kyungpook National University Chilgok Hospital from May 2016 to April 2018 were retrospectively reviewed. The feasibility of candidates for outpatient management according to the guideline was evaluated based on the outcomes. A total of 114 patients were enrolled and categorized into two groups, low-risk (38.6%) and high-risk (61.4%). The proportion of feasible candidates for outpatient management was 70.2% and was higher in the low-risk than in the high-risk group (90.0% vs. 57.1%; P < 0.001). The low-risk group had no mortality, no resistance to oral amoxicillin/clavulanate or ciprofloxacin, a higher rate of successful empirical antibiotics, and lower rates of glycopeptide or carbapenem administration. A significant number of hospitalized cancer patients treated for FN after chemotherapy were found to be feasible candidates for outpatient management. The guideline can be a useful tool to reduce labor of healthcare workers and hospitalization costs.
Keyphrases
- end stage renal disease
- newly diagnosed
- ejection fraction
- healthcare
- chronic kidney disease
- pseudomonas aeruginosa
- risk factors
- peritoneal dialysis
- squamous cell carcinoma
- cardiovascular disease
- emergency department
- escherichia coli
- adipose tissue
- chemotherapy induced
- skeletal muscle
- cystic fibrosis
- papillary thyroid
- multidrug resistant
- patient reported outcomes
- weight loss
- electronic health record
- adverse drug