Evaluation of the clinical Index of Stable febrile neutropenia risk stratification system for management of febrile neutropenia in gynecologic oncology patients.

Autor:	Monuszko KA; Duke University School of Medicine, Durham, NC, 27710, United States., Albright B; Division of Gynecologic Oncology, Duke Cancer Institute, Durham, NC, 27710, United States., Katherine Montes De Oca M; Department of Obstetrics & Gynecology, Duke University, Durham, NC, 27710, United States., Thao Thi Nguyen N; Duke University School of Medicine, Durham, NC, 27710, United States., Havrilesky LJ; Division of Gynecologic Oncology, Duke Cancer Institute, Durham, NC, 27710, United States., Davidson BA; Division of Gynecologic Oncology, Duke Cancer Institute, Durham, NC, 27710, United States.
Jazyk:	angličtina
Zdroj:	Gynecologic oncology reports [Gynecol Oncol Rep] 2021 Aug 27; Vol. 37, pp. 100853. Date of Electronic Publication: 2021 Aug 27 (Print Publication: 2021).
DOI:	10.1016/j.gore.2021.100853
Abstrakt:	Objective: Scoring systems have been developed to identify low risk patients with febrile neutropenia (FN) who may be candidates for outpatient management. We sought to validate the predictive accuracy of the Clinical Index of Stable Febrile Neutropenia (CISNE) score alone and in conjunction with alternative scoring systems for risk of complications among gynecologic oncology patients. Methods: We conducted a single institution retrospective cohort study of patients admitted to an academic gynecologic oncology service for FN. We examined the performance characteristics (sensitivity, specificity, positive and negative predictive value) of three scoring systems (Multinational Association of Supportive Care in Cancer (MASCC), CISNE cut-off 1 (Low risk = 0), CISNE cut-off 2 (Low risk = <3)), and the combination of MASCC and CISNE to predict complications: inpatient death, ICU admission, hypotension, respiratory/renal failure, mental status change, cardiac failure, bleeding, and arrhythmia. Results: Fifty patients were identified for study inclusion. No low-risk CISNE patients died during hospitalization. Fewer CISNE low-risk patients experienced complications compared to high-risk patients, regardless of cut-off. Sensitivity, specificity, positive and negative predictive values of the scoring systems were: CISNE 1-37.1%, 86.7%, 86.7%, 37.1%; CISNE 2-85.7%, 46.7%, 78.9%, 58.3%; MASCC-82.9%, 66.7%, 85.3%, 62.5%; MASCC + CISNE 1-37.1%, 93.3%, 92.9%, 38.9%; MASCC + CISNE 2-80%, 73.3%, 87.5%, 61.1%. Conclusions: The CISNE scoring system is an appropriate tool for the identification of patients with gynecologic cancers and FN who may benefit from close outpatient management. CISNE cut-off 2 performed comparably to the MASCC, but CISNE cut-off 1 had a higher specificity and positive predictive value. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2021 Published by Elsevier Inc.)
Databáze:	MEDLINE
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